Abstract:
INTRODUCTION:A surgical approach to airway management may be essential in situations of difficult or failed airway, where immediate airway access is needed to provide oxygenation. However, the procedure is uncommonly performed and expertise among emergency clinicians may be limited. OBJECTIVES:The aim of this study was to assess the accuracy of cricothyroid membrane (CTM) identification by junior and senior emergency trainees by identification of surface anatomy landmarks. A secondary aim was to determine patient variables associated with accurate identification of CTM. METHODS:A prospective observational study was conducted in a tertiary emergency department in the Kingdom of Saudi Arabia. Saudi Emergency Medicine board trainees participated in the study. Data were also obtained on gender and body habitus of patients. Junior trainees attempted to locate the membrane by palpation and marked it with an ultraviolet mark (blinded) pen followed by senior trainees. A certified ultrasound physician, also blinded to the trainee attempts, marked the membrane within a 5 mm circumference using a different coloured ultraviolet pen and was used as the reference gold standard. RESULTS:There were 80 patients enrolled with junior and senior doctors assessing location for emergency cricothyrotomy. Proportion of correct localisation was 30% (95% CI 20% to 41%) among junior trainees and 33% (95% CI 22% to 44%) among seniors (P=0.73). Level of training, sex, height and weight of patients were not associated with success. CONCLUSIONS:Clinical localisation of CTM by emergency medicine trainees was poor even in non-stressful settings, and warrants further dedicated education and/or use of adjunct techniques.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Alshareef H,Al Saawi A,Almazroua F,Alyami H,Reilly GO,Mitra Bdoi
10.1136/postgradmedj-2018-135828subject
Has Abstractpub_date
2018-08-01 00:00:00pages
442-445issue
1114eissn
0032-5473issn
1469-0756pii
postgradmedj-2018-135828journal_volume
94pub_type
杂志文章abstract::A case of ovarian carcinoma and systemic amyloidosis in a 64 year old woman with nephrotic syndrome is reported. Immunohistochemical study of renal and rectal biopsy specimens revealed the presence of amyloidosis AA antigens, consistent with secondary amyloidosis. The absence of chronic inflammatory or infectious dise...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.70.825.505
更新日期:1994-07-01 00:00:00
abstract::A previously fit man developed psittacosis with marked cerebellar symptoms and signs. He was febrile but not confused, and he responded rapidly to treatment with erythromycin. Even if respiratory symptoms are minimal, psittacosis and other atypical pneumonias should be considered in any patient presenting with fever a...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.64.751.382
更新日期:1988-05-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
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更新日期:2020-12-03 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.66.782.1078
更新日期:1990-12-01 00:00:00
abstract::The empty sella syndrome (ESS) presents a varied clinical and radiographic picture. It may remain asymptomatic or may stimulate an intrasellar growth thereby causing diagnostic and therapeutic problems. An air encephalogram (AEG) is required for diagnosis. The purpose of this paper is to review the clinical and radiol...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.52.613.703
更新日期:1976-11-01 00:00:00
abstract::The efficacy of ranitidine (150 mg twice daily) and cimetidine (200 mg three times daily and 400 mg at night) in the short-term healing of duodenal ulcer has been assessed in a randomized controlled trial involving 106 patients. There were 3 drop-outs. Forty-two out of 53 patients (79%) treated with ranitidine had hea...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/pgmj.59.688.88
更新日期:1983-02-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.57.663.66
更新日期:1981-01-01 00:00:00
abstract::Two female patients who suffered from drug-induced thrombocytopenic purpura and subendocardial myocardial infarction are presented. One of them died from cerebral haemorrhage and diffuse subendocardial punctate haemorrhages were found at post-mortem. The abnormal haemostasis which is associated with thrombocytopenia m...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.55.639.36
更新日期:1979-01-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1993-02-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
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更新日期:2009-03-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
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更新日期:2016-01-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::Bile acid, neutral sterol and faecal fat excretion was studied over a period of 9 weeks in a group of 16 healthy subjects before, during and after administration of fenfluramine. Statistical analysis revealed a significant increase in bile acid excretion during the drug phase (P less than 0.02); and during recovery pe...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.55.641.180
更新日期:1979-03-01 00:00:00
abstract::It has long been recognised that intensive efforts are needed to reform medical education in order to meet the future needs of populations worldwide. Pressure for changes to the organisation, content and delivery of both undergraduate and postgraduate medical education has greatly increased in the last two decades. Th...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.71.837.397
更新日期:1995-07-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:2003-12-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.68.799.355
更新日期:1992-05-01 00:00:00
abstract::The risk of developing an overt malignancy after an isolated deep venous thrombosis (DVT) is poorly documented. We therefore reviewed a series of patients in whom a solitary idiopathic DVT had been proven by venography at least 12 months earlier. No patient had developed a malignancy at follow-up. However, decreased f...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.60.702.275
更新日期:1984-04-01 00:00:00
abstract::Weekly low dose methotrexate is an established treatment for rheumatoid arthritis, but its use in elderly people has not been adequately examined. The aim of this study was to evaluate its safety in elderly patients with rheumatoid arthritis. A retrospective review of the clinical records of rheumatoid arthritis patie...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.76.902.787
更新日期:2000-12-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
doi:10.1136/postgradmedj-2017-134945
更新日期:2017-11-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1980-12-01 00:00:00
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更新日期:1999-01-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章,多中心研究
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更新日期:2006-02-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.67.789.649
更新日期:1991-07-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.65.761.180
更新日期:1989-03-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.654.268
更新日期:1980-04-01 00:00:00
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journal_title:Postgraduate medical journal
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更新日期:1997-09-01 00:00:00
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doi:10.1136/qshc.2006.021071
更新日期:2008-02-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.78.919.281
更新日期:2002-05-01 00:00:00