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Robab Mehdizadeh Esfanjani - One of the best experts on this subject based on the ideXlab platform.

  • Role of anesthesiology curriculum in improving bag-mask ventilation and intubation success rates of emergency medicine residents: a prospective descriptive study
    BMC Emergency Medicine, 2011
    Co-Authors: Hassan Soleimanpour, Changiz Gholipouri, Jafar Rahimi Panahi, Mohammad Reza Afhami, Rouzbeh Rajaei Ghafouri, Samad Ej Golzari, Maryam Soleimanpour, Robab Mehdizadeh Esfanjani
    Abstract:

    Background Rapid and safe airway management has always been of paramount importance in successful management of critically ill and injured patients in the emergency department. The purpose of our study was to determine success rates of bag-mask ventilation and tracheal intubation performed by emergency medicine residents before and after completing their anesthesiology curriculum. Methods A prospective descriptive study was conducted at Nikoukari Hospital, a teaching hospital located in Tabriz, Iran. In a skills lab, a total number of 18 emergency medicine residents (post graduate year 1) were given traditional intubation and bag-mask ventilation instructions in a 36 hour course combined with mannequin practice. Later the residents were given the opportunity of receiving training on airway management in an operating room for a period of one month which was considered as an additional training program added to their Anesthesiology Curriculum. Residents were asked to ventilate and intubate 18 patients (Mallampati class I and ASA class I and II) in the operating room; both before and after completing this additional training program. Intubation achieved at first attempt within 20 seconds was considered successful. Successful bag-mask ventilation was defined as increase in ETCo_2 to 20 mm Hg and back to baseline with a 3 L/min fresh gas-flow and the adjustable pressure limiting Valve at 20 cm H_2O. An attending anesthesiologist who was always present in the operating room during the induction of anesthesia confirmed the endotracheal intubation by direct laryngoscopy and capnography. Success rates were recorded and compared using McNemar, marginal homogeneity and paired t-Test tests in SPSS 15 software. Results Before the additional training program in the operating room, the participants had intubation and bag-mask ventilation success rates of 27.7% (CI 0.07-0.49) and 16.6% (CI 0-0.34) respectively. After the additional training program in the operating room the success rates increased to 83.3% (CI 0.66-1) and 88.8% (CI 0.73-1), respectively. The differences in success rates were statistically significant (P = 0.002 and P = 0.0004, respectively). Conclusions The success rate of emergency medicine residents in airway management improved significantly after completing anesthesiology rotation. Anesthesiology rotations should be considered as an essential component of emergency medicine training programs. A collateral curriculum of this nature should also focus on the acquisition of skills in airway management.

  • Role of anesthesiology curriculum in improving bag-mask ventilation and intubation success rates of emergency medicine residents: a prospective descriptive study.
    BMC emergency medicine, 2011
    Co-Authors: Hassan Soleimanpour, Changiz Gholipouri, Mohammad Reza Afhami, Rouzbeh Rajaei Ghafouri, Samad Ej Golzari, Maryam Soleimanpour, Jafar Panahi, Robab Mehdizadeh Esfanjani
    Abstract:

    Rapid and safe airway management has always been of paramount importance in successful management of critically ill and injured patients in the emergency department. The purpose of our study was to determine success rates of bag-mask ventilation and tracheal intubation performed by emergency medicine residents before and after completing their anesthesiology curriculum. A prospective descriptive study was conducted at Nikoukari Hospital, a teaching hospital located in Tabriz, Iran. In a skills lab, a total number of 18 emergency medicine residents (post graduate year 1) were given traditional intubation and bag-mask ventilation instructions in a 36 hour course combined with mannequin practice. Later the residents were given the opportunity of receiving training on airway management in an operating room for a period of one month which was considered as an additional training program added to their Anesthesiology Curriculum. Residents were asked to ventilate and intubate 18 patients (Mallampati class I and ASA class I and II) in the operating room; both before and after completing this additional training program. Intubation achieved at first attempt within 20 seconds was considered successful. Successful bag-mask ventilation was defined as increase in ETCo2 to 20 mm Hg and back to baseline with a 3 L/min fresh gas-flow and the adjustable pressure limiting Valve at 20 cm H2O. An attending anesthesiologist who was always present in the operating room during the induction of anesthesia confirmed the endotracheal intubation by direct laryngoscopy and capnography. Success rates were recorded and compared using McNemar, marginal homogeneity and paired t-Test tests in SPSS 15 software. Before the additional training program in the operating room, the participants had intubation and bag-mask ventilation success rates of 27.7% (CI 0.07-0.49) and 16.6% (CI 0-0.34) respectively. After the additional training program in the operating room the success rates increased to 83.3% (CI 0.66-1) and 88.8% (CI 0.73-1), respectively. The differences in success rates were statistically significant (P = 0.002 and P = 0.0004, respectively). The success rate of emergency medicine residents in airway management improved significantly after completing anesthesiology rotation. Anesthesiology rotations should be considered as an essential component of emergency medicine training programs. A collateral curriculum of this nature should also focus on the acquisition of skills in airway management.

Hassan Soleimanpour - One of the best experts on this subject based on the ideXlab platform.

  • Role of anesthesiology curriculum in improving bag-mask ventilation and intubation success rates of emergency medicine residents: a prospective descriptive study
    BMC Emergency Medicine, 2011
    Co-Authors: Hassan Soleimanpour, Changiz Gholipouri, Jafar Rahimi Panahi, Mohammad Reza Afhami, Rouzbeh Rajaei Ghafouri, Samad Ej Golzari, Maryam Soleimanpour, Robab Mehdizadeh Esfanjani
    Abstract:

    Background Rapid and safe airway management has always been of paramount importance in successful management of critically ill and injured patients in the emergency department. The purpose of our study was to determine success rates of bag-mask ventilation and tracheal intubation performed by emergency medicine residents before and after completing their anesthesiology curriculum. Methods A prospective descriptive study was conducted at Nikoukari Hospital, a teaching hospital located in Tabriz, Iran. In a skills lab, a total number of 18 emergency medicine residents (post graduate year 1) were given traditional intubation and bag-mask ventilation instructions in a 36 hour course combined with mannequin practice. Later the residents were given the opportunity of receiving training on airway management in an operating room for a period of one month which was considered as an additional training program added to their Anesthesiology Curriculum. Residents were asked to ventilate and intubate 18 patients (Mallampati class I and ASA class I and II) in the operating room; both before and after completing this additional training program. Intubation achieved at first attempt within 20 seconds was considered successful. Successful bag-mask ventilation was defined as increase in ETCo_2 to 20 mm Hg and back to baseline with a 3 L/min fresh gas-flow and the adjustable pressure limiting Valve at 20 cm H_2O. An attending anesthesiologist who was always present in the operating room during the induction of anesthesia confirmed the endotracheal intubation by direct laryngoscopy and capnography. Success rates were recorded and compared using McNemar, marginal homogeneity and paired t-Test tests in SPSS 15 software. Results Before the additional training program in the operating room, the participants had intubation and bag-mask ventilation success rates of 27.7% (CI 0.07-0.49) and 16.6% (CI 0-0.34) respectively. After the additional training program in the operating room the success rates increased to 83.3% (CI 0.66-1) and 88.8% (CI 0.73-1), respectively. The differences in success rates were statistically significant (P = 0.002 and P = 0.0004, respectively). Conclusions The success rate of emergency medicine residents in airway management improved significantly after completing anesthesiology rotation. Anesthesiology rotations should be considered as an essential component of emergency medicine training programs. A collateral curriculum of this nature should also focus on the acquisition of skills in airway management.

  • Role of anesthesiology curriculum in improving bag-mask ventilation and intubation success rates of emergency medicine residents: a prospective descriptive study.
    BMC emergency medicine, 2011
    Co-Authors: Hassan Soleimanpour, Changiz Gholipouri, Mohammad Reza Afhami, Rouzbeh Rajaei Ghafouri, Samad Ej Golzari, Maryam Soleimanpour, Jafar Panahi, Robab Mehdizadeh Esfanjani
    Abstract:

    Rapid and safe airway management has always been of paramount importance in successful management of critically ill and injured patients in the emergency department. The purpose of our study was to determine success rates of bag-mask ventilation and tracheal intubation performed by emergency medicine residents before and after completing their anesthesiology curriculum. A prospective descriptive study was conducted at Nikoukari Hospital, a teaching hospital located in Tabriz, Iran. In a skills lab, a total number of 18 emergency medicine residents (post graduate year 1) were given traditional intubation and bag-mask ventilation instructions in a 36 hour course combined with mannequin practice. Later the residents were given the opportunity of receiving training on airway management in an operating room for a period of one month which was considered as an additional training program added to their Anesthesiology Curriculum. Residents were asked to ventilate and intubate 18 patients (Mallampati class I and ASA class I and II) in the operating room; both before and after completing this additional training program. Intubation achieved at first attempt within 20 seconds was considered successful. Successful bag-mask ventilation was defined as increase in ETCo2 to 20 mm Hg and back to baseline with a 3 L/min fresh gas-flow and the adjustable pressure limiting Valve at 20 cm H2O. An attending anesthesiologist who was always present in the operating room during the induction of anesthesia confirmed the endotracheal intubation by direct laryngoscopy and capnography. Success rates were recorded and compared using McNemar, marginal homogeneity and paired t-Test tests in SPSS 15 software. Before the additional training program in the operating room, the participants had intubation and bag-mask ventilation success rates of 27.7% (CI 0.07-0.49) and 16.6% (CI 0-0.34) respectively. After the additional training program in the operating room the success rates increased to 83.3% (CI 0.66-1) and 88.8% (CI 0.73-1), respectively. The differences in success rates were statistically significant (P = 0.002 and P = 0.0004, respectively). The success rate of emergency medicine residents in airway management improved significantly after completing anesthesiology rotation. Anesthesiology rotations should be considered as an essential component of emergency medicine training programs. A collateral curriculum of this nature should also focus on the acquisition of skills in airway management.

Prabhat Rawal - One of the best experts on this subject based on the ideXlab platform.

  • In Vitro Study of Magnetic Resonance Imaging Artifacts of Anesthetic Devices
    Medical Journal of Shree Birendra Hospital, 2016
    Co-Authors: Uday Bajracharya, Prabhat Rawal
    Abstract:

    Introduction: Deep sedation or general anesthesia is usually required for Magnetic Resonance Imaging when patients cannot remain motionless in the suite. Various anesthetic devices have been used to maintain the airway and ventilate the lungs during this period but some of them produce artifacts that pose difficulties in the interpretation of images. The aim of this study was to identify the devices that produced artifacts during Magnetic Resonance Imaging. Methods: Twelve anesthetic devices were considered: oro-pharyngeal airway, naso-pharygeal airway, face mask with reservoir bag, nasal cannula, endotracheal tube, disposable Ambu Laryngeal Mask Airway, Laryngeal Mask Airway Unique, Disposable Laryngeal Tube Sonda, i-gel, Ambubag, Bain Circuit, Jackson Rees Circuit.Magnetic Resonance Imaging was performed with each device placed on the top of a phantom simulator respectively to resemble the position in vivo. Results: The artifacts with Disposable Laryngeal Tube Sonda, Laryngeal Mask Airway Unique and endotracheal tube were related to ferromagnetic material in the pilot Valve were similar. No artifacts were found with oro-pharyngeal airway, naso-pharygeal airway, nasal cannula, endo-tracheal tube with pilot Valve detached, face masks with reservoir bag (metal removed), Ambu bag (without  Adjustable Pressure Limiting Valve), i-gel , disposable  Ambu Laryngeal Mask Airway, Bain Circuit and  Jackson Rees Circuit. Conclusions: Anesthetic devices not containing any ferromagnetic material are recommended for use during MRI scanning to reduce artifacts.

  • In vitro study of Magnetic Resonance Imaging artifacts of anesthetic devices
    Journal of Society of Anesthesiologists of Nepal, 2015
    Co-Authors: Uday Bajracharya, Prabhat Rawal
    Abstract:

    Background: Deep sedation or general anesthesia is usually required for Magnetic Resonance Imaging when patients cannot remain motionless in the suite. Various anesthetic devices have been used to maintain the airway and ventilate the lungs during this period. Some of them produce artifacts that pose difficulties in the interpretation of images. The aim of this study was to identify the devices that produced artifacts during Magnetic Resonance Imaging. Methods: Twelve anesthetic devices were considered: oro-pharyngeal airway, nasopharygeal airway, face mask with reservoir bag, nasal cannula, endotracheal tube, disposable Ambu Laryngeal Mask Airway, Laryngeal Mask Airway Unique, Disposable Laryngeal Tube Sonda, i-gel, Ambu bag, Bain Circuit, Jackson Rees Circuit. Magnetic Resonance Imaging was performed with each device placed on the top of a phantom simulator respectively to resemble the position in vivo. Results: The artifacts with Disposable Laryngeal Tube Sonda, Laryngeal Mask Airway Unique and endotracheal tube were related to ferromagnetic material in the pilot Valve and were similar. No artifacts were found with oro-pharyngeal airway, nasopharygeal airway, nasal cannula, endo-tracheal tube with pilot Valve detached, face masks with reservoir bag (metal removed), Ambu bag (without Adjustable Pressure Limiting Valve), i-gel , disposable Ambu Laryngeal Mask Airway, Bain Circuit and Jackson Rees Circuit. Conclusion: Anesthetic devices that produce Magnetic Resonance Imaging artifacts are disposable Laryngeal Tube Sonda, Laryngeal Mask Airway Unique and Endotracheal Tube. Journal of Society of Anesthesiologists of Nepal 2015; 2(1): 13-16

  • In vitro study of Magnetic Resonance Imaging artifacts of anesthetic
    2015
    Co-Authors: Prabhat Rawal
    Abstract:

    Background: Deep sedation or general anesthesia is usually required for Magnetic Resonance Imaging when patients cannot remain motionless in the suite. Various anesthetic devices have been used to maintain the airway and ventilate the lungs during this period. Some of them produce artifacts that pose difficulties in the interpretation of images. The aim of this study was to identify the devices that produced artifacts during Magnetic Resonance Imaging. Methods: Twelve anesthetic devices were considered: oro-pharyngeal airway, nasopharygeal airway, face mask with reservoir bag, nasal cannula, endotracheal tube, disposable Ambu Laryngeal Mask Airway, Laryngeal Mask Airway Unique, Disposable Laryngeal Tube Sonda, i-gel, Ambu bag, Bain Circuit, Jackson Rees Circuit. Magnetic Resonance Imaging was performed with each device placed on the top of a phantom simulator respectively to resemble the position in vivo. Results: The artifacts with Disposable Laryngeal Tube Sonda, Laryngeal Mask Airway Unique and endotracheal tube were related to ferromagnetic material in the pilot Valve and were similar. No artifacts were found with oro-pharyngeal airway, nasopharygeal airway, nasal cannula, endo-tracheal tube with pilot Valve detached, face masks with reservoir bag (metal removed), Ambu bag (without Adjustable Pressure Limiting Valve), i-gel , disposable Ambu Laryngeal Mask Airway, Bain Circuit and Jackson Rees Circuit.

Mark C Mammel - One of the best experts on this subject based on the ideXlab platform.

  • observational study of humidified high flow nasal cannula compared with nasal continuous positive airway pressure
    The Journal of Pediatrics, 2009
    Co-Authors: Andrea L Lampland, Brenda Plumm, Patricia Meyers, Cathy Worwa, Mark C Mammel
    Abstract:

    Objectives To conduct an in vitro evaluation of a humidified high-flow nasal cannula (HFNC) system at different flows, cannula sizes, and air leaks and also an in vivo analysis of mean end-expiratory esophageal pressure (EEEP) from nasal continuous positive airway pressure at 6 cm H 2 O (NCPAP+6) versus HFNC. Study design In the in vitro study, we measured HFNC system pressure and flow, with varying degrees of leak and with and without the use of a Pressure-Limiting Valve. In the in vivo study, we measured EEEP in 15 newborns on NCPAP+6 and then on HFNC at 6 L/minute, with flow decreased by 1 L/minute every 30 minutes. Heart rate, respiratory rate, fraction of inspired oxygen, arterial oxygen saturation, respiratory distress syndrome score, and EEEP were recorded for each intervention. Data analysis was done using repeated-measures analysis of variance and linear regression. Results In the in vitro study, in the absence of leaks, the pressures were limited by the Pressure-Limiting Valve only at flows ≥ 2 L/minute. With leaks of 30% and 50%, delivered pressures were always 2 O. In the in vivo study, respiratory rate increased from baseline (NCPAP+6) as flow decreased ( P Conclusions A Pressure-Limiting Valve is necessary in a HFNC system. Although mean EEEP levels were similar in NCPAP+6 and HFNC, tachypnea developed as flow diminished. This system apparently cannot predict EEEP, because of interpatient and intrapatient variation.

Maryam Soleimanpour - One of the best experts on this subject based on the ideXlab platform.

  • Role of anesthesiology curriculum in improving bag-mask ventilation and intubation success rates of emergency medicine residents: a prospective descriptive study
    BMC Emergency Medicine, 2011
    Co-Authors: Hassan Soleimanpour, Changiz Gholipouri, Jafar Rahimi Panahi, Mohammad Reza Afhami, Rouzbeh Rajaei Ghafouri, Samad Ej Golzari, Maryam Soleimanpour, Robab Mehdizadeh Esfanjani
    Abstract:

    Background Rapid and safe airway management has always been of paramount importance in successful management of critically ill and injured patients in the emergency department. The purpose of our study was to determine success rates of bag-mask ventilation and tracheal intubation performed by emergency medicine residents before and after completing their anesthesiology curriculum. Methods A prospective descriptive study was conducted at Nikoukari Hospital, a teaching hospital located in Tabriz, Iran. In a skills lab, a total number of 18 emergency medicine residents (post graduate year 1) were given traditional intubation and bag-mask ventilation instructions in a 36 hour course combined with mannequin practice. Later the residents were given the opportunity of receiving training on airway management in an operating room for a period of one month which was considered as an additional training program added to their Anesthesiology Curriculum. Residents were asked to ventilate and intubate 18 patients (Mallampati class I and ASA class I and II) in the operating room; both before and after completing this additional training program. Intubation achieved at first attempt within 20 seconds was considered successful. Successful bag-mask ventilation was defined as increase in ETCo_2 to 20 mm Hg and back to baseline with a 3 L/min fresh gas-flow and the adjustable pressure limiting Valve at 20 cm H_2O. An attending anesthesiologist who was always present in the operating room during the induction of anesthesia confirmed the endotracheal intubation by direct laryngoscopy and capnography. Success rates were recorded and compared using McNemar, marginal homogeneity and paired t-Test tests in SPSS 15 software. Results Before the additional training program in the operating room, the participants had intubation and bag-mask ventilation success rates of 27.7% (CI 0.07-0.49) and 16.6% (CI 0-0.34) respectively. After the additional training program in the operating room the success rates increased to 83.3% (CI 0.66-1) and 88.8% (CI 0.73-1), respectively. The differences in success rates were statistically significant (P = 0.002 and P = 0.0004, respectively). Conclusions The success rate of emergency medicine residents in airway management improved significantly after completing anesthesiology rotation. Anesthesiology rotations should be considered as an essential component of emergency medicine training programs. A collateral curriculum of this nature should also focus on the acquisition of skills in airway management.

  • Role of anesthesiology curriculum in improving bag-mask ventilation and intubation success rates of emergency medicine residents: a prospective descriptive study.
    BMC emergency medicine, 2011
    Co-Authors: Hassan Soleimanpour, Changiz Gholipouri, Mohammad Reza Afhami, Rouzbeh Rajaei Ghafouri, Samad Ej Golzari, Maryam Soleimanpour, Jafar Panahi, Robab Mehdizadeh Esfanjani
    Abstract:

    Rapid and safe airway management has always been of paramount importance in successful management of critically ill and injured patients in the emergency department. The purpose of our study was to determine success rates of bag-mask ventilation and tracheal intubation performed by emergency medicine residents before and after completing their anesthesiology curriculum. A prospective descriptive study was conducted at Nikoukari Hospital, a teaching hospital located in Tabriz, Iran. In a skills lab, a total number of 18 emergency medicine residents (post graduate year 1) were given traditional intubation and bag-mask ventilation instructions in a 36 hour course combined with mannequin practice. Later the residents were given the opportunity of receiving training on airway management in an operating room for a period of one month which was considered as an additional training program added to their Anesthesiology Curriculum. Residents were asked to ventilate and intubate 18 patients (Mallampati class I and ASA class I and II) in the operating room; both before and after completing this additional training program. Intubation achieved at first attempt within 20 seconds was considered successful. Successful bag-mask ventilation was defined as increase in ETCo2 to 20 mm Hg and back to baseline with a 3 L/min fresh gas-flow and the adjustable pressure limiting Valve at 20 cm H2O. An attending anesthesiologist who was always present in the operating room during the induction of anesthesia confirmed the endotracheal intubation by direct laryngoscopy and capnography. Success rates were recorded and compared using McNemar, marginal homogeneity and paired t-Test tests in SPSS 15 software. Before the additional training program in the operating room, the participants had intubation and bag-mask ventilation success rates of 27.7% (CI 0.07-0.49) and 16.6% (CI 0-0.34) respectively. After the additional training program in the operating room the success rates increased to 83.3% (CI 0.66-1) and 88.8% (CI 0.73-1), respectively. The differences in success rates were statistically significant (P = 0.002 and P = 0.0004, respectively). The success rate of emergency medicine residents in airway management improved significantly after completing anesthesiology rotation. Anesthesiology rotations should be considered as an essential component of emergency medicine training programs. A collateral curriculum of this nature should also focus on the acquisition of skills in airway management.