Conclusion, in the preliminary analysis of this study the rate of colonization tended to be

Conclusion, in the preliminary analysis of this study the rate of colonization tended to be increased in the closed aspiration system group when PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20719924 compared with the open aspiration system group. However, there was no difference between the groups in terms of the development of VAP and mortality in the ICU.Open (n = 24) Age Male gender APACHE II Duration of MV Rate of colonization* Development of VAP Length of stay in the ICU Mortality in the ICU 64.7 ?3.9 9 (37.5 ) 23.6 ?1.4 6.6 ?0.9 11 (57.9 ) 6 (25 ) 10.1 ?1.5 18 (75 ) Close (n = 20) 63.6 ?3.0 12 (60 ) 27.4 ?1.6 8.7 ?1.2 14 (82.4 ) 7 (35 ) 12.2 ?1.7 16 (80 ) P 0.83 0.22 0.08 0.16 0.16 0.52 0.36 0.* n = 19 in the open aspiration system group and n = 17 in the closed aspiration system group.PA laboratory assessment of the learning and retention of skills required to use the Combitube and Laryngeal Mask Airway by non-anaesthetistsC Coles, C Elding, M Mercer Department of Anaesthesia, Frenchay Hospital, Bristol BS16 1LE, UK Both the Combitube and Laryngeal Mask Airway (LMA) have been successfully used by non-anaesthetists during resuscitation [1?]. However, only one study (using the Combitube) has assessed how well these skills are retained after the initial training period. Here, nine of 11 paramedics demonstrated inadequate skill retention in the follow-up study at 15 months [6]. Study purpose: To assess and compare the ability of non-anaesthetists to learn and retain the skills necessary to use the Combitube and Laryngeal Mask STING-Inducer-1 ammonium salt supplier Airways. Method: With no prior warning, 10 non-anaesthetists (3 student nurses, 2 qualified nurses and 5 trainee operating department practitioners) took part in a study morning covering theoretical aspects of Combitube and LMA insertion and use, and a practical demonstration and practice session. This was followed by a written examination of 30 yes/no questions and a practical assessment for each airway device. Eight weeks later, again with no prior warning, the same 10 people retook the same written examinations and practical assessments. Results: The mean decrease in score between the first and second visits was ?.3 (95 confidence limits, ?.13 to ?.47; P < 0.05) for the Combitube, and ?.5 (95 confidence limits, 0.63 to ?.63; P < 0.5) for the LMA. Conclusion: This study suggests that the practical use of the Combitube is an easier skill to acquire than the LMA. Not surprisingly retention of theoretical and practical skills for both the Combitube and LMA deteriorated over a short time span (although not reaching statistical significance for theoretical LMA scores). When patients failed to respond to tracheal extubation, the PAEC was used to facilitate reintubation of these difficult airways. Results: The study population consisted of seven patients undergone neck surgery, seven postoperative patients with maxillofacial trauma, five patients with cerebral infarct, three patients undergone maxillofacial cancer surgery, two patients with head injury and one patient with ankylosing spondylitis. Following tracheal extubation, 2 of 25 patients who undergone neck surgery required reintubation because of excessive airway obstruction due to surgical bleeding and bronchospasm related to aspiration. These patients desaturated progressively and they could not be ventilated properly by face mask after sedatives were given for reintubation. Reintubation was urgently achieved over the Cook PAEC and was easily accomplished on the first attempt without the need of an alternate.