A model for the relationship between airway mucosal dysfunction and the combination of the humidity of inspired gas and the duration over which the airway mucosa is exposed to that humidity is proposed. This model suggests that there is an optimal temperature and humidity above which, and below which, there is impaired mucosal function. This optimal level of temperature and humidity is core temperature and 100% relative humidity. However, existing data are only sufficient to test this model for gas conditions below core temperature and 100% relative humidity. These data concur with the model in that region. No studies have yet looked at this relationship beyond 24 hrs. Longer exposure times to any given level of inspired humidity and inspired gas temperatures and humidities above core temperature and 100% relative humidity need to be studied to fully verify the proposed model.
Within emergency care settings, rapid sequence intubation (RSI) is frequently used to secure a definitive airway (i.e., endotracheal tube) to provide optimal oxygenation and ventilation in critically ill patients of all ages. For providers in these settings, a deeper understanding of the indications, associated medications, and adjunctive techniques may maximize success with this common procedure. Identification of difficult airways, using mnemonics and standardized criteria prior to the procedure allows, the clinician additional time for assimilation of additional resources and tools to increase the likelihood of first-pass success with intubation. This article describes tools for the procedure of RSI, including the "7 Ps" checklist of intubation.
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