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Comparison of five video-assisted intubation devices by novice and expert laryngoscopists for use in the aeromedical evacuation environment

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Military Medical Research 2017年第2期4卷 61-69页

作者： Matthew C.Wallace SSgt Tyler Britton Robbie Meek Sharon Walsh-Hart col todd e.carter Steven J.Lisco University of Cincinnati Medical Center Department of Anesthesiology

Background: The critically ill or injured patient undergoing military medical evacuation may require emergent intubation. Intubation may be life-saving, but it carries *** novice or infrequent laryngoscopist has a distinct disadvantage because experience is critical for the rapid and safe establishment of a secured airway. This challenge is compounded by the austere environment of the back of an aircraft under blackout conditions. This study determined which of five different video-assisted intubation devices(VAIDs) was best suited for in-flight use by U.S. Air Force Critical Care Air Transport Teams by comparing time to successful intubation between novice and expert laryngoscopists under three conditions, Normal Airway Lights on(NAL), Difficult Airway Lights on(DAL) and Difficult Airway Blackout(DAB), using manikins on a standard military transport stanchion and the floor with a minimal amount of setup time and extraneous light ***: A convenience sample size of 40 participants(24 novices and 16 experts) attempted intubation with each of the 5 different video laryngoscopic devices on high-fidelity airway manikins. Time to tracheal intubation and number of optimization maneuvers used were recorded. Kruskal-Wallis testing determined significant differences between the VAIDs in time to intubation for each particular scenario. Devices with significant differences underwent pair-wise comparison testing using rank-sum analysis to further clarify the difference. Device assembly times, startup times and the amount of light emitted were recorded. Perceived ease of use was surveyed. Results: Novices were fastest with the Pentax AWS in all difficult airway scenarios. experts recorded the shortest median times consistently using 3 of the 5 devices. The AWS was superior overall in 4 of the 6 scenarios tested. experts and novices subjectively judged the Glide Scope Ranger as easiest to use. The light emitted by all the devices was less than the USAF-issued hea

关键词： simulation difficult airway novice expert military video laryngoscopy light emission

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effect of human disturbance on the structure and regeneration of forests in the Nevado de Toluca National Park, Mexico

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Journal of Forestry Research 2012年第1期23卷 39-44页

作者： Angel Rolando endara Agramont Sergio Franco Maass Gabino Nava Bernal Juan Ignacio Valdez Hernández todd S.Fredericksen Instituto de Ciencias Agropecuarias y Rurales(ICAR) Universidad Autónoma del Estado de MéxicoInstituto Literario N°100Col.Centro.PO.Box 50000.TolucaMéxico colegio de Posgraduados Carretera México-TexcocoKm.36.5Montecillo.PO.Box 56230TexcocoMéxico School of Natural Sciences and Mathematics Ferrum CollegeP.O.Box 1000Ferrum VA 24088USA

Sample plots were established in the principal forest types in the the Nevado de Toluca National Park, Mexico including those domi- nated by Pinus hartwegii, Abies religiosa, Quercus laurina and Alnus jorullensis. The vertical structure was defined by three strata in the coniferous forests and two strata in the broadleaved forests. Timber harvesting in Abies religiosa and Quercus laurina forests and fires generated by humans in Pinus hartwegii forests impeded the recruitment of saplings. Mature trees were also heavily impacted by logging in Pinus hartwegii forests. On the contrary, Alnusjorullensis forests were increas- ing due to the disturbance of Pinus and Quercus forests, as well aban- doned crop lands within the park. A combination of logging, uncon- trolled fire, and grazing appears to be compromising the recruitment of important tree species in this national park. These factors, together with human settlements, have also increased the proportion of early succes- sional species. Changes in forest structure from human disturbance indicate a need to control these activities if conservation goals are not to be compromised.

关键词： forest structure human disturbance mountain forests

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