The use of the Airtraq® optical laryngoscope for routine tracheal intubation in high-risk cardio-surgical patients

<p>Abstract</p> <p>Background</p> <p>The Airtraq^®optical laryngoscope (Prodol Ltd., Vizcaya, Spain) is a novel disposable device facilitating tracheal intubation in routine and difficult airway patients. No data investigating routine tracheal intubation using the Airtaq^®in patients at a high cardiac risk are available at present. Purpose of this study was to investigate the feasibility and hemodynamic implications of tracheal intubation with the Aitraq^®optical laryngoscope, in high-risk cardio-surgical patients.</p> <p>Methods</p> <p>123 consecutive ASA III patients undergoing elective coronary artery bypass grafting were routinely intubated with the Airtraq^®laryngoscope. Induction of anesthesia was standardized according to our institutional protocol. All tracheal intubations were performed by six anesthetists trained in the use of the Airtraq^®prior.</p> <p>Results</p> <p>Overall success rate was 100% (n = 123). All but five patients trachea could be intubated in the first attempt (95,9%). 5 patients were intubated in a 2nd (n = 4) or 3rd (n = 1) attempt. Mean intubation time was 24.3 s (range 16-128 s). Heart rate, arterial blood pressure and SpO₂were not significantly altered. Minor complications were observed in 6 patients (4,8%), i.e. two lesions of the lips and four minor superficial mucosal bleedings. Intubation duration (p = 0.62) and number of attempts (p = 0.26) were independent from BMI and Mallampati score.</p> <p>Conclusion</p> <p>Tracheal intubation with the Airtraq^®optical laryngoscope was feasible, save and easy to perform in high-risk patients undergoing cardiac surgery. In all patients, a sufficient view on the vocal cords could be obtained, independent from BMI and preoperative Mallampati score.</p> <p>Trial Registration</p> <p>DRKS 00003230</p

Monitoring the Effectiveness of Phragmites australis Treatment for the Great Lakes Coastline

Millions of dollars have been spent on herbicide and other control measures of the form of the wetland plant Phragmites australis, but few efforts have included monitoring to assess the effectiveness of treatment on habitat restoration and biodiversity. A study was conducted to analyze field and remote sensing data in a nested design to develop recommendations for standardized methods for monitoring treatment success. Through field sampling, paired treated and non-treated Phragmites dominant sites were assessed in Green Bay and Saginaw Bay for biodiversity of birds, amphibians, and vegetation. Aerial and satellite imagery at various scales were used to map treatment success at the landscape scale. Remote sensing data provides the spatial context of the distribution of live Phragmites plants including leading edges, and it also provides documentation of the location of dead Phragmites vegetation regrowth and spatial context with adjacent lands. Field data provide an assessment of the biodiversity of a site and presence of rare or endangered species. Both field and remote sensing-based monitoring are needed for adaptive management strategies in controlling Phragmites. The main findings of this research, including a comparison of the impacts of treatment efforts in Green Bay and Saginaw Bay, will be presente

Rapid response tools and datasets for post-fire hydrological modeling applied to the High Park Fire

Post-fire flooding and erosion can pose a serious threat to life, property and natural resources. Time is critical in post-fire remediation as plans and treatments must be developed and deployed before the first major storms to be effective. We have developed an interactive database for the continental United States to facilitate rapid assessment of runoff and erosion risks from burned watersheds. This interactive database allows modelers to upload earth observations of soil burn severity and quickly download spatially-explicit model inputs at either 10- or 30-m resolution for process-based models, particularly WEPP based models (http://geodjango.mtri.org/geowepp/). Other modeling applications include agriculture, construction, or mining. The online database has allowed post-fire remediation teams in the western U.S. to rapidly predict post-fire erosion and effects of mulching treatments for over a dozen fires ranging in size from 4-540 km2. There is an urgent need for field data to validate these modeling efforts. One of the first fires to utilize this database was the High Park Fire, which burned approximately 330 km2 in northcentral Colorado in June 2012. Beginning in late summer of 2012 rainfall, site characteristics, and sediment production were measured for 21 unmulched and 8 mulched hillslopes. In 2013 sediment yields from unmulched and mulched hillslopes averaged 7.9 and 3.0 Mg ha-1, respectively, and these values dropped by more than an order of magnitude in 2014. Initial comparisons of measured and predicted hillslope sediment yields were poorly correlated, although they are of a similar order of magnitude. The causes of the poor correlation are being evaluated, and include a discrepancy between the small scale of the measured hillslopes and the much larger scale of the modeled hillslopes, problems with some sediment fences overtopping, an exceptionally large and long duration storm in September 2013, and the lack of suspended sediment data. Additional modeling is being conducted to obtain a better match between the predicted and measured hillslopes; and to model specific subsets of the data to minimize problems with the measured sediment yields and the effect of the September storm. These results will be used to both validate and recalibrate post-fire soil parameters for WEPP based models