PubMed · 6908503
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D Schmich, M Booth-Dunn. 1981. Ruby Gumdrop: OR teaching aid.. https://doi.org/10.1016/s0001-2092(07)63007-5
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BACKGROUND: Pediatric airway management traditionally emphasizes strict adherence to age-based laryngoscope blade size recommendations, despite limited empirical validation. OBJECTIVES: To evaluate whether intubation performance varies across a range of blade sizes, and whether a Macintosh 2 blade performs comparably across multiple pediatric age groups in a simulation setting. METHODS: We conducted a randomized crossover simulation study using three pediatric airway manikins (neonate, infant, and child age groups). Emergency medicine residents and faculty physicians performed intubations using multiple laryngoscope blade types and sizes, including standard and nonstandard options. Primary outcomes were intubation time and first-attempt success. Secondary outcomes included complications and operator-rated ease of glottic view and tube passage. Between-blade differences were estimated with 95% confidence intervals. RESULTS: Across manikin sizes and blade types, intubation times were short and first-attempt success rates exceeded 98% in most conditions. Performance remained consistent even with blade sizes outside conventional age-based recommendations. Between-blade differences in intubation time were small, and complication rates were low across conditions. The Macintosh 2 blade performed comparably across all manikin sizes, with similar intubation times, high success rates, and favorable ease ratings. CONCLUSIONS: Intubation performance in pediatric manikin models was similar across a wide range of blade sizes. These hypothesis-generating findings warrant prospective clinical evaluation of simplified blade selection strategies for pediatric intubation.
The absorbed doses in the body of a Rando-Alderson phantom were measured in rotational panoramic radiography (OP-5) with LiF-700 crystals using conventional intensifying screens and standard collimator, as well as rare earth intensifying screens and a collimator slit of reduced width. The reduction of the absorbed doses obtained by using the latter combination was calculated. The reduction range in different regions was 0-50%. The greatest reduction was obtained in the cranial part of the phantom. In the caudal part little or no reduction was observed, probably because leakage radiation contributes substantially to the absorbed doses in this area. The average dose equivalent was calculated for organs in which measurements were made in several locations. The reduction was about 50% for these organs except for the gonads (8%). Compared to the estimated average annual dose equivalent originating from the natural background radiation sources, the dose equivalent resulting from this X-ray examination was very small except in the thyroid gland. In this organ the dose equivalent from one exposure corresponded to 36 days of natural background radiation, but it could be reduced to 18 days by using rare earth intensifying screens in combination with reduced beam width.
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