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{
    "pk": 9126,
    "title": "Direct Versus Video Laryngoscopy for Intubating Adult Patients with Gastrointestinal Bleeding",
    "subtitle": null,
    "abstract": "Introduction: \nVideo laryngoscopy (VL) has been advocated for several aspects of emergency airway management; however, there are still concerns over its use in select patient populations such as those with large volume hematemesis secondary to gastrointestinal (GI) bleeds. Given the relatively infrequent nature of this disease process, we sought to compare intubation outcomes between VL and traditional direct laryngoscopy (DL) in patients intubated with GI bleeding, using the third iteration of the National Emergency Airway Registry (NEARIII).\nMethods: \nWe performed a retrospective analysis of a prospectively collected national database (NEARIII) of intubations performed in United States emergency departments (EDs) from July 1, 2002, through December 31, 2012. All cases where the indication for intubation was “GI bleed” were analyzed. We included patient, provider and intubation characteristics. We compared data between intubation attempts initiated as DL and VL using parametric and non-parametric tests when appropriate.\nResults: \nWe identified 325 intubations, 295 DL and 30 VL. DL and VL cases were similar in terms of age, sex, weight, difficult airway predictors, operator specialty (emergency medicine, anesthesia or other) and level of operator training (post-graduate year 1, 2, etc). Proportion of successful first attempts (DL 261/295 (88.5%) vs. VL 28/30 (93.3%) p=0.58) and Cormack-Lehane grade views (p=0.89) were similar between devices. The need for device change was similar between DL [2/295 (0.7%) and VL 1/30 (3.3%); p=0.15].\nConclusion: \nIn this national registry of intubations performed in the ED for patients with GI bleeds, both DL and VL had similar rates of success, glottic views and need to change devices.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "video laryngoscopy, intubation, gastrointestinal hemorrhage"
        }
    ],
    "section": "Technology in Emergency Medicine",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/36k6k24z",
    "frozenauthors": [
        {
            "first_name": "Jestin",
            "middle_name": "N.",
            "last_name": "Carlson",
            "name_suffix": "",
            "institution": "Saint Vincent Hospital, Department of Emergency Medicine, Erie, Pennsylvania",
            "department": "None"
        },
        {
            "first_name": "Jason",
            "middle_name": "",
            "last_name": "Crofts",
            "name_suffix": "",
            "institution": "Saint Vincent Hospital, Department of Emergency Medicine, Erie, Pennsylvania",
            "department": "None"
        },
        {
            "first_name": "Ron",
            "middle_name": "M.",
            "last_name": "Walls",
            "name_suffix": "",
            "institution": "Brigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Calvin",
            "middle_name": "A.",
            "last_name": "Brown III",
            "name_suffix": "",
            "institution": "Brigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        }
    ],
    "date_submitted": "2015-07-09T15:51:57Z",
    "date_accepted": "2015-07-09T15:51:57Z",
    "date_published": "2015-12-01T18:50:44Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/9126/galley/5117/download/"
        }
    ]
}