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Gag Reflex

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61. Nasopharyngeal airway (NPA)

is to be sized correctly in patients: if the airway is too short it will fail to separate the soft palate from the pharynx and if too long it can pass into the larynx and aggravate cough and gag reflexes ( ). The NPA primarily acts as a 'splint' which maintains patency of the airway, or keeps the tongue from falling back on the posterior pharyngeal wall and occluding the airway, therefore preventing airway obstruction, hypoxia and asphyxia ( ). NPAs are generally well tolerated by conscious children

2014 Publication 1593

62. Mouth care

to swallow or observe the swallowing process. Ask the parent/carer if there are any notable changes. Observe the swallowing process to check the child or young person's ability to do so, any pain experienced, or pooling/dribbling of secretions. If there are any doubts about the swallow and gag reflex, the child or young person should be referred to a speech and language therapist for further assessment. Lips and corner of the mouth Observe the appearance of tissue. It should be smooth, pink and moist

2014 Publication 1593

64. Shark Fin morphology recognized only by EM physician

with no clinical information and my immediate response was: "Shark fin! This patient is likely post-ROSC or peri-ROSC, right? LAD occlusion." I then sent it to Dr. Smith who said: "Just another shark fin. Should be obvious." The cath lab was activated immediately based on this ECG. iStat labs revealed hypokalemia of 2.2 mEq/L and pH 7.08 (VBG). He was given 300 mg rectal ASA and loaded with 4000U heparin. Soon after establishing a perfusing rhythm, the patient was gagging and coughing against the endotracheal (...) tube indicating intact brainstem reflexes. He had recurrent VFib several times requiring defbrillation with ROSC each time. Epinephrine drip was added for additional inotropy. The cardiology team arrived and another repeat ECG was obtained: Similar to first ECG. It has been 20 minutes since sustained ROSC, therefore the findings are likely not simply due to low flow during arrest (assuming the patient has had at least several minutes of at least decent coronary perfusion pressure, and this patient

2019 Dr Smith's ECG Blog

66. Low-dose Succinylcholine to Facilitate Laryngeal Mask Airway Insertion: A Comparison of Two Doses. Full Text available with Trip Pro

Low-dose Succinylcholine to Facilitate Laryngeal Mask Airway Insertion: A Comparison of Two Doses. Around the world, the use of the laryngeal mask airway (LMA) is becoming more common for different surgeries accounting for it being the dominant choice of airway in numerous surgeries. Although propofol is known to blunt the laryngeal reflexes often patient movement, coughing, and gagging occur on insertion. This study aims to identify the optimum dose of succinylcholine required to facilitate (...) hospital in Southern India.Patients were induced with 2 mg/kg of propofol, after 2 μg/kg of fentanyl. The study drug was given after loss of consciousness. After 60 s, a classic LMA was inserted by the standard method by a single investigator. Jaw relaxation, coughing, gagging, movement, laryngospasm, ease of insertion, number of attempts, propofol usage, and hemodynamics were assessed.Statistical methods used were analysis of variance with Bonferroni's t-test, Chi-square test, and Fisher's test. P

2019 Anesthesia, essays and researches Controlled trial quality: uncertain

67. The Effect of Glossopharyngeal Nerve Block on Post-Tonsillectomy Pain of Children; Randomized Controlled Trial. Full Text available with Trip Pro

of pethidine rescue analgesia, and the incidence of postoperative complications were all assessed. Moreover, response to gag reflex, degree of difficulty in swallowing, and parents' satisfaction were recorded.Bilateral glossopharyngeal nerve block in children presented for adeno-tonsillectomy significantly prolonged the time for the first request of rescue analgesia, compared to the control group, reaching 5.833 ± 2.667 hours (P < 0.0001). It also decreased postoperative pethidine consumption to 0.878 (...) ± 0.387 mg/kg (P = 0.0009). Moreover, it significantly decreased the postoperative FLACC score assessed two, four, six, and twelve hours after surgery, during rest and swallowing (P < 0.05). The response to gag reflex and difficulty in swallowing were also significantly decreased (P ≤ 0.0001 and 0.006, respectively). In addition, glossopharyngeal nerve block significantly increased parents' satisfaction (P = 0.0002), with no significant increase in the incidence of postoperative complications (P

2019 Anesthesiology and pain medicine Controlled trial quality: uncertain

68. Early postoperative oral feeding shortens first time of bowel evacuation and prevents long term hospital stay in patients undergoing elective small intestine anastomosis. (Abstract)

, postoperative care should be revised as well. Early postoperative oral feeding was studied in trauma and burn. However, there are few trials among patients after major surgeries.This randomized single-blinded controlled trial was performed on 108 patients who had small intestine anastomosis at Imam Hossein Medical Centre in 2012. The patients were randomly assigned to schedule EOF (with starting oral feeding on the first day after surgery and complete return of the Gag reflex) or TOF (with delaying oral

2019 Gastroenterology and hepatology from bed to bench Controlled trial quality: uncertain

70. Fetus delivery time in extraperitoneal versus transperitoneal cesarean section: a randomized trial. (Abstract)

tubal ligation were excluded from the study. The primary outcome of the study was the skin incision-to-delivery time. The sample size was set to detect of 1-minute difference in fetal delivery time between groups (two-tailed hypothesis, α = 0.05, β = 0.10). Secondary outcome measures were total operation time, intraoperative nausea, gag reflex, vomiting, pain and anxiety for those receiving regional anesthesia, postoperative pain, change in hemoglobin, postoperative analgesic requirements, nausea

2018 The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians Controlled trial quality: uncertain

71. Efficacy and safety of using premedication with simethicone/Pronase during upper gastrointestinal endoscopy examination with sedation: A single center, prospective, single blinded, randomized controlled trial. Full Text available with Trip Pro

lidocaine hydrochloride mucilage (LHM, N = 314) and premedication used in the intervention group was 80 mL simethicone/Pronase solution plus 10 mL lidocaine hydrochloride mucilage (SP/LHM, N = 296). EGD was done under sedation. Visibility scores, number of mucosal areas that needed cleansing, water consumption for cleansing, time taken for examination, diminutive lesions, pathological diagnosis, patients' gag reflex and oxygenation (pulse oximetry) were recorded.SP/LHM has significantly lower total (...) rate of diagnosis of atrophic gastritis (P = 0.014) and intestinal metaplasia (P = 0.024). There was no significant difference in gag reflex (P = 0.604) and oxygenation during the endoscopy procedure for either group of patients.Routine use of premedication with simethicone/Pronase should be recommended during EGD with sedation.© 2017 Japan Gastroenterological Endoscopy Society.

2018 Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society Controlled trial quality: uncertain

72. Clinical marginal fit of zirconia crowns and patients' preferences for impression techniques using intraoral digital scanner versus polyvinyl siloxane material. (Abstract)

, size of impression tray/scanner, gag reflex, and overall preference. Computer-aided design and computer-aided manufacturing monolithic zirconia crowns were fabricated from both impressions. The crowns were evaluated intraorally, and a blinded examiner measured the marginal discrepancy of silicone replicas under a stereomicroscope. Intraexaminer reliability was evaluated by calculating the intraclass correlation coefficient. Data for patients' preferences and marginal discrepancies were analyzed

2018 The Journal of prosthetic dentistry Controlled trial quality: uncertain

73. Complete dentures: an update on clinical assessment and management: part 2. (Abstract)

on the management of edentulous patients. This second part focuses on the copy denture technique as well as discussing strategies for assessing and managing gag reflexes, prominent palatal and lingual tori and microstomia.

2018 British Dental Journal

74. Role of Ultrasound in Laryngeal Lesions

, not all patients can tolerate the laryngoscope especially those with a sensitive gag reflex, patients with limit of jaw or neck mobility or patients suffering from stridor. It is also difficult in most infants and children . Even during laryngoscopy the exact extension of laryngeal tumor, its infiltration and invasion of the laryngeal skeleton can sometimes be hard to assess. Thus, laryngoscopy alone may not be sufficient in some cases to judge the extent of infiltrative processes or measure the exact

2018 Clinical Trials

75. Combined Conventional Speech Therapy and Functional Electrical Stimulation in Dysphagia Following Stroke

for dysphagia - PARD [ Time Frame: 5 days (before and immediately after intervention) ] Before feeding: Comprehensive language, oral reflexes(vomiting, trismus, deglutition) and sialorrhea- present or absent Inside oral and facial sensitivity- present or reduced During feeding (liquid, thick and pasty): Captation, anterior and posterior escape, cough reflex and gagging- present or absent Oral transit time, number of swallowing, laryngeal elevation- adequate or inadequate Voice normal or "wet" Functional (...) swallowing- there are changes that do not compromise safe feeding as reduced sensitivity (intra-oral or facial), anterior escape due to small anatomical or functional changes Mild dysphagia- multiple swallowing, inadequate laryngeal elevation, "wet" voice but cough reflex efficient Moderate dysphagia- multiple swallowing, inadequate laryngeal elevation, "wet" voice, weak cough reflex and gagging one or more consistencies Severe dysphagia- when there is no evidence of coughing, swallowing reflexes

2018 Clinical Trials

76. Protocolized Ventilator Weaning Verses Usual Care

and the result of a SBT. Pre-defined weaning criteria included: (1) patent upper airway; (2) ability to protect airway (defined by mental status and presence of adequate gag and cough reflexes); (3) ability to clear secretions; (4) decreasing secretion burden requiring suction not more frequently than every 2 hours; (5) level of support (FiO2 < 50%, PEEP = 5); and (6) hemodynamic stability not requiring chemical (vasopressors, inotropes) or mechanical (e.g. intra-aortic balloon pump, extracorporeal life (...) . At the end of the SBT, the RSBI was re-measured and an arterial blood gas (ABG) was obtained. In the UC group, the SBT type and extubation decision was determined by the attending intensivist on service based upon neurologic status, airway competence (gag, cough, suction requirements), and negative inspiratory force (NIF) or RSBI measurements. Extubation success was defined as remaining extubated for 48 hours without need for re-intubation or other forms of non-invasive MV. Study Design Go to Layout

2018 Clinical Trials

77. MEBO Ointment and Hyaluronic Acid Gel in the Management of Pain After Free Gingival Graft Harvesting

Eligible for Study: 21 Years to 62 Years (Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: Yes Criteria Inclusion Criteria: Patients with mucogingival defects scheduled for free gingival graft Systemically healthy Exclusion Criteria: Smokers Occlusal trauma at site of graft Pregnancy and lactation Patients allergic to the used agents Severe gagging reflex Contacts and Locations Go to No Contacts or Locations Provided More Information Go to Publications: Layout table for additonal

2018 Clinical Trials

78. Neurological Prognostications for the Therapeutic Hypothermia among Comatose Survivors of Cardiac Arrest Full Text available with Trip Pro

(PLR) and/or gag reflex after rewarming, and the absence of at least one of the brainstem reflexes, no eye-opening, or abnormal motor response on the 7th day. Myoclonus and seizure could not be used to indicate poor prognosis. In addition, prognostic values of EEG and CT findings were inconclusive.Our study showed the simple neurological signs helped predict short-term neurological prognosis. The most reliable sign determining unfavorable outcome was the lack of PLR. The optimal time to assess

2018 Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine

79. The Determination of an Appropriate Time for Placement of the Classic Laryngeal Mask Airway in Patients Undergoing General Anesthesia Full Text available with Trip Pro

selected based on the following prerequisites, patients' age, gender, easy intubation, need for additional drug administration, basic blood pressure before drug administration, within the time intervals one, three, and five minutes after placement of LMA, duration of LMA, SaO2 before and after placement of LMA, coughing, patient's movement, laryngospasm, gag reflex after intubation, allowing appropriate ventilation, presence of sore throat after surgery, number of attempts, extent of mouth opening

2018 Anesthesiology and pain medicine

80. Bilateral total retinal detachment at birth: a case report of Walker–Warburg syndrome Full Text available with Trip Pro

hydrocephalus that had increased throughout pregnancy, and a diagnosis of hydrancephaly was made at 36 weeks of gestation. Hypotonia, cleft lip and palate, poor suck and absent gag reflex were noted at birth. Ophthalmic examination at the age of 2 days revealed bilateral funnel retinal detachment. B-scan ultrasonography confirmed these findings, and magnetic resonance imaging (MRI) of the brain was performed at the age of 13 days to establish a diagnosis. The MRI showed lissencephaly, hydrocephalus and thin

2018 International medical case reports journal

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