Airway control in case of a mass toxicological event: superiority of second-generation supraglottic airway devices

Ophir, Nimrod; Ramaty, Erez; Rajuan-Galor, Inbal; Rosman, Yossi; Lavon, Ophir; Shrot, Shai; Shiyovich, Arthur; Huerta-Hartal, Michael; Kassirer, Michael; Vaida, Sonia; Gaitini, Luis

doi:10.1016/j.ajem.2014.08.067

Cited by 9 publications

(14 citation statements)

References 33 publications

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“…In most cases, especially when there is no significant intoxication of personnel, this is an extreme and unnecessary step. Mass intoxication may result in respiratory failure or respiratory muscles paralysis that can lead to a high prevalence of mortality [6,17]. Nonetheless, many events that occurred in the past did not develop into such severe MCIs; the problem is that a mass psychogenic illness may evolve, enhanced by the confusion and excitement that are often associated with toxicological or chemical events [7,18].…”

Section: Characteristics Of Toxicological/chemical Threatsmentioning

confidence: 99%

“…In the past decade, the international community witnessed several MCIs that resulted from the use of toxicological and/or chemical agents [5,6]. Although this emergent threat has taxed the capacities of diverse societies and potentially may transpire in any community, to date it is perceived as occurring only infrequently, and thus constitutes a potential though uncommon risk [4].…”

Section: Introductionmentioning

confidence: 99%

“…Since the 11 September 2001 attack in the USA, the interest of governing authorities, as well as of the media and the public, expanded to include chemical and toxicological threats [6]. Many states invest significant resources in building their capacity to manage such events and mitigate their consequences, but nonetheless, it has been stated that such efforts have been too limited and, as of yet, many deficiencies in the level of emergency preparedness are still predominant [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Maintaining Preparedness to Severe Though Infrequent Threats—Can It Be Done?

Siman‐Tov

Davidson

Adini

2020

IJERPH

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Background: A mass casualty incident (MCI) caused by toxicological/chemical materials constitutes a potential though uncommon risk that may cause great devastation. Presentation of casualties exposed to such materials in hospitals, if not immediately identified, may cause secondary contamination resulting in dysfunction of the emergency department. The study examined the impact of a longitudinal evaluation process on the ongoing emergency preparedness of hospitals for toxicological MCIs, over a decade. Methods: Emergency preparedness for toxicological incidents of all Israeli hospitals were periodically evaluated, over ten years. The evaluation was based on a structured tool developed to encourage ongoing preparedness of Standard Operating Procedures (SOPs), equipment and infrastructure, knowledge of personnel, and training and exercises. The benchmarks were distributed to all hospitals, to be used as a foundation to build and improve emergency preparedness. Scores were compared within and between hospitals. Results: Overall mean scores of emergency preparedness increased over the five measurements from 88 to 95. A significant increase between T1 (first evaluation) and T5 (last evaluation) occurred in SOPs (p = 0.006), training and exercises (p = 0.003), and in the overall score (p = 0.004). No significant changes were found concerning equipment and infrastructure and knowledge; their scores were consistently very high throughout the decade. An interaction effect was found between the cycles of evaluation and the hospitals’ geographical location (F (1,20) = 3.0, p = 0.056), proximity to other medical facilities (F (1,20) = 10.0 p = 0.005), and type of area (Urban vs. Periphery) (F (1,20) = 13.1, p = 0.002). At T5, all hospitals achieved similar high scores of emergency preparedness. Conclusions: Use of accessible benchmarks, which clearly delineate what needs to be continually implemented, facilitates an ongoing sustenance of effective levels of emergency preparedness. As this was demonstrated for a risk that does not frequently occur, it may be assumed that it is possible and practical to achieve and maintain emergency preparedness for other potential risks.

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Section: Characteristics Of Toxicological/chemical Threatsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Maintaining Preparedness to Severe Though Infrequent Threats—Can It Be Done?

Siman‐Tov

Davidson

Adini

2020

IJERPH

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“…Anesthesiologists may need to intubate patients wearing PPE, which may impair airway visualization, encumber manual dexterity, and result in prolonged intubation times. A supraglottic airway can be a faster way to establish an airway while in PPE or during difficult intubations, but it should be replaced by an endotracheal tube when deemed safe [45]. There is no difference in intubation times when comparing direct laryngoscopy to video laryngoscopy while wearing PPE; both intubating techniques are reasonable choices [46,47].…”

Section: Airway Managementmentioning

confidence: 99%

Emergency Preparedness and Mass Casualty Considerations for Anesthesiologists

Kuza

McIsaac

2018

Advances in Anesthesia

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“…Hier konnten, zumindest mittels Phantomversuch mit den bekannten Limitationen der Übertragbarkeit auf die klinische Praxis [24,27], Anwendungsvorteile der EGA allgemein im Vergleich mit der ETI gezeigt werden [38], ohne dass zwischen LM oder LT ein signifikanter Unterschied bestand [8,38] …”

Section: Ergebnisseunclassified

Larynxmaske oder Larynxtubus

Mann

Lenz

et al. 2015

Notfall Rettungsmed

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Extraglottische Atemwege (EGA) sind aktuell etablierter Bestandteil des modernen Rettungsdienstes in Deutschland [31]. Als Alternativverfahren für die endotracheale Intubation sind EGA ein wichtiges Hilfsmittel beim Management des schwierigen Atemwegs. Im Vergleich zur endotrachealen Intubation (ETI), dem Goldstandard der Atemwegssicherung, werden die Vorteile der EGA in der leichteren Erlernbarkeit bzw. dem geringeren Übungsaufwand zum Routineerhalt [48], der schnelleren Anwendbarkeit (z. B. Reduktion der "noflow-time" bei Reanimationen) [18] oder

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Airway control in case of a mass toxicological event: superiority of second-generation supraglottic airway devices

Cited by 9 publications

References 33 publications

Maintaining Preparedness to Severe Though Infrequent Threats—Can It Be Done?

Maintaining Preparedness to Severe Though Infrequent Threats—Can It Be Done?

Emergency Preparedness and Mass Casualty Considerations for Anesthesiologists

Larynxmaske oder Larynxtubus

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