The theory and method of comparative area studies

Though many now downplay the tension between area studies and disciplinary political science, there has been little substantive guidance on how to accomplish complementarity between their respective approaches. This article seeks to develop the idea of comparative area studies (CAS) as a rubric that maintains the importance of regional knowledge while contributing to general theory building using inductive intra-regional, cross-regional, inter-regional comparison. Treating regions as theoretically-grounded analytical categories, rather than inert or innate geographical entities, can help inform both quantitative and qualitative attempts to build general theory.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Cannula cricothyroidotomy in the impalpable neck: An observational study of simulated ‘can’t intubate, can’t oxygenate’ scenarios by teams following a cannula-first algorithm in live anaesthetised pigs

Live animal models can be used to train anaesthetists to perform emergency front-of-neck-access. Cannula cricothyroidotomy success reported in previous wet lab studies contradicts human clinical data. This prospective, observational study reports success of a cannula-first ‘can't intubate, can't oxygenate’ algorithm for impalpable anatomy during high fidelity team simulations using live, anaesthetised pigs. Forty-two trained anaesthesia teams were instructed to follow the Royal Perth Hospital can't intubate, can't oxygenate algorithm to re-oxygenate a desaturating pig with impalpable neck anatomy (mean (standard deviation, SD) 16.2 (3.5) kg); mean (SD) tracheal internal diameter 11 (1.4) mm. Teams were informed that failure would prompt veterinary-led euthanasia. All teams performed percutaneous cannula cricothyroidotomy as the initial technique, with a median (interquartile range, IQR (range)) start time of 42 (35–50 (24–93)) s. First-pass percutaneous cannula success was 29% to both insufflate tracheal oxygen and re-oxygenate. Insufflation success improved with repeated percutaneous attempts (up to three), but prolonged hypoxia time increasingly necessitated euthanasia (insufflation 57%; re-oxygenation 48%). First, second and third percutaneous attempts achieved insufflation at median (IQR (range)) 74 (64–91 (46–110)) s, 111 (95–136 (79–150)) s and 141 (127–159 (122–179)) s, respectively. Eighteen teams failed with percutaneous cannulae and performed scalpel techniques, predominantly dissection cannulation (n = 17) which achieved insufflation in all cases (insufflation 100%; re-oxygenation 47%). Scalpel attempts were started at median (IQR (range)) 142 (133–218 (97–293)) s and achieved insufflation at 232 (205–303 (152–344)) s. While percutaneous cannula cricothyroidotomy could rapidly re-oxygenate, the success rate was low and teams repeated attempts beyond the recommended 60 s time frame, delaying transition to the more successful dissection cannula technique. We recommend this ‘cannula-first’ can't intubate, can't oxygenate algorithm adopts a ‘single best effort’ strategy for percutaneous cannula, with failure prompting a scalpel technique