RESUMEN
Tracheal intubation through a laryngeal mask airway is one option for securing an airway in the patient with a difficult airway. A variety of techniques and equipment have been used to stabilize the position of the tracheal tube while removing the laryngeal mask airway. We have shown that if a fibreoptic bronchoscope is used to place an tracheal tube through a laryngeal mask in neonates, additional equipment is not needed to remove the laryngeal mask airway without endangering tracheal tube placement. This is possible even in small neonates.
Asunto(s)
Intubación Intratraqueal/métodos , Máscaras Laríngeas , Broncoscopía , Tecnología de Fibra Óptica , Humanos , Recién Nacido , Intubación Intratraqueal/instrumentación , MasculinoRESUMEN
OBJECTIVE: To assess pediatricians' knowledge about the epidemiology of childhood drowning, their opinions and current practices regarding its prevention, and their interest in taking on more responsibility for its prevention. DESIGN: A self-administered questionnaire was mailed to 800 pediatricians in the United States, randomly selected from the American Academy of Pediatrics' approximately 18,000 full fellows. RESULTS: A total of 560 completed surveys were returned, a response rate of 70.1%. Although 85% of respondents believe it is the responsibility of pediatricians to become involved in community and/or legislative efforts to prevent childhood drowning, only 4.1% were involved in such efforts. Only a minority of respondents provided written materials and anticipatory guidance on drowning prevention to their patients. Women were more likely than men to discuss drowning prevention with their patients. Younger physicians were more likely than older physicians to discuss drowning prevention with their patients. Physicians who received formal education on drowning prevention during their pediatric residency training were more likely to provide written materials and anticipatory guidance on drowning prevention to their patients. However, only 17.9% of respondents received formal education on drowning prevention during their pediatric residency training. Seventy-four percent of all respondents felt that further education on the prevention of childhood drowning and near-drowning would be useful to them. CONCLUSION: Although drowning is the second leading cause of death by unintentional injury in the pediatric population (aged 0 to 19 years), most pediatricians do not routinely provide information to their patients, or to their patients' parents, on drowning prevention. IMPLICATION: Pediatricians have been effective child advocates in many areas of injury prevention. If the prevention of drowning is made a priority in pediatric practice, many more children's lives will be saved.