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Gag Reflex

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141. Articles of the month (April 2016)

breathing, marked change in tone, or altered level of responsiveness An event doesn’t count as a BRUE if there is a likely explanation (probably the biggest change from ALTE) Choking and gagging are specifically not considered BRUEs because they usually have an explanation such as GERD or URI A low risk BRUE is defined as all of: age >60 days, born ≥ 32 weeks and gestational age ≥ 45 weeks, no CPR by a trained medical provider, event < 1 min, and first event. For these children, they specifically say (...) ) and were given ketamine. 44 of the 49 were adequately sedated with ketamine, and 4 of the 5 not sedated were given less than 200mg ketamine IM. There were only 3 adverse events: 2 patients vomited, and 1 had his oxygen saturation drop to 90%. This obviously isn’t practice changing in itself, but ketamine is a very interesting option for sedating agitated patients because of its ability to keep respiratory drive and airway reflexes in tact. Bottom line: Ketamine is an interesting option for managing

2016 First10EM

142. A survey of the intravenous sedation status in one provincial dental clinic center for the disabled in Korea (PubMed)

January 2011 and May 2016. The analysis examined the patient's sex, age, primary reason for IV sedation, duration of anesthesia and dental treatment, type of dental treatment performed, number of clinical departments involved in the dental treatment and level of multidisciplinary cooperation, and annual trends.Most dental treatments using intravenous sedation were performed on medically disabled patients or dentally disabled patients with an extreme gag reflex or dental phobia. The mean duration of IV

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2016 Journal of Dental Anesthesia and Pain Medicine

143. Management of patients with stroke: Identification and management of dysphagia

on videofluoroscopy fail to cough. 26 Risk of aspiration is suggested by the following: 36,37 ? wet, hoarse voice ? weak voluntary cough ? any indication of reduced laryngeal function. Reduced conscious level is also an indicator of aspiration risk. 37 The gag reflex is unreliable and insensitive as an independent predictor 26 and should only be used as part of a more detailed assessment procedure (see section 3). 38 One screening study suggests that reduced pharyngeal sensation may be associated with aspiration

2010 SIGN

146. Cardiopulmonary Syndromes (PDQ®): Health Professional Version

judiciously and sparingly; they are unpleasant to the taste and obtund the gag reflex, and anaphylactic reactions to preservatives in these solutions have been documented. Opioid and nonopioid antitussives, such as dextromethorphan, may act synergistically, but further studies are required to confirm this hypothesis.[ ] Gabapentin was found to be efficacious compared with placebo for chronic refractory cough, although this study did not specifically include cancer patients.[ ] In cases of increased sputum

2014 PDQ - NCI's Comprehensive Cancer Database

147. Halitosis

, than cleaning the tongue with a toothbrush. Use a gentle scraping action, and avoid excessive scraping as this can cause damage and bleeding to the tongue. Care should be taken to avoid triggering the gag reflex. Additional information Antibacterial toothpastes and mouthwashes These preparations are widely available from supermarkets and pharmacies. Antibacterial agents that are included in mouthwashes and toothpastes include cetylpyridinium chloride, chlorhexidine, hexetidine, hydrogen peroxide

2014 NICE Clinical Knowledge Summaries

148. Jeffrey Aronson: When I use a word . . . Medical onomatopoeia

borborygmi in the chest have been reported in . To gag is to strangle or suffocate, imitating the sound made in choking. Hence, the gag reflex. By transference, a gag is something used to stop up the mouth or to keep the jaws open during surgery. Gagging for air is choking, but, in case you thought we’d worked back up the body again, gagging for it is being desperate for something altogether different. Jeffrey Aronson is a clinical pharmacologist, working in the Centre for Evidence Based Medicine

2015 The BMJ Blog

149. Cadaveric donation: brain stem death

maintained on mechanical ventilators. Brain stem death is diagnosed by performing, on two separate occasions, five simple tests which verify that: (1) the pupils are fixed and dilated and do not react to light; (2) there is no eye movement; (3) there is no ear reflex; (4) there is no pain response; and, (5) there is no gag reflex. Globally, brain death is clinically adjudged as the death of an individual. It is a clinical declaration of death whereby an individual’s life is clinically considered to have (...) their cardio-respiratory system is continuously maintained on mechanical ventilators. Brain stem death is diagnosed by performing, on two separate occasions, five simple tests which verify that: (1) the pupils are fixed and dilated and do not react to light; (2) there is no eye movement; (3) there is no ear reflex; (4) there is no pain response; and, (5) there is no gag reflex. Globally, brain death is clinically adjudged as the death of an individual. It is a clinical declaration of death whereby

2015 Evidence-Based Nursing blog

150. The AMA acts to try to rein in doctors spreading misinformation

being "muzzled" or "gagged" is utter nonsense. Medical professional societies have the right—no, the duty—to uphold professional standards, and this is all that the AMA is trying to do. In the overall scheme of things, the AMA's action probably won't do much by itself. But if it serves as a start, an action that inspires other professional societies and—dare I dream it?—even state medical boards to follow suit, it could have a real impact. Imagine, for instance, not just Dr. Oz facing professional (...) about vaccines. And if that jibes with any of a number of different confirmation biases you might have, your guard goes up without thinking too much about it: Maybe there's something to this! I don't want to take a chance with my kid! Nobody gets measles anymore anyway! Better safe than sorry... As long as this mental process stays in the background, it can proliferate. Pull it all up to the front of consciousness, really look into it past the reflex phase, and it's a very different story. Too often

2015 Respectful Insolence

152. Determining brain death in adults

of the temporomandibular joints and deep pressure at the supraorbital ridge should produce no grimacing or facial muscle movement. Absence of the pharyngeal and tracheal reflexes. The pharyngeal or gag reflex is tested after stimulation of the posterior pharynx with a tongue blade or suction device. The tracheal reflex is most reliably tested by examining the cough response to tracheal suctioning. The catheter should be inserted into the trachea and advanced to the level of the carina followed by 1 or 2 suctioning (...) integrity ensured) □ Oculovestibular reflex absent □ No facial movement to noxious stimuli at supraorbital nerve, temporomandibular joint □ Gag reflex absent □ Cough reflex absent to tracheal suctioning □ Absence of motor response to noxious stimuli in all 4 limbs (spinally mediated reflexes are permissible) Apnea testing (all must be checked) □ Patient is hemodynamically stable □ Ventilator adjusted to provide normocarbia (PaCo 2 34–45 mm Hg) □ Patient preoxygenated with 100% FiO 2 for > 10 minutes

2010 American Academy of Neurology

153. A Study to Determine if Caffeine Accelerates Emergence From Anesthesia

: Caffeine Anesthetized volunteers will be allowed to wake after injection of either saline (placebo control) or caffeine (15 mg/ kg). The time to wake will be measured. Drug: Caffeine Anesthetized volunteers will be allowed to wake after injection of caffeine (15 mg/ kg). The time to wake will be measured. Other Name: Caffeine citrate Outcome Measures Go to Primary Outcome Measures : Waking Time - Re-establishment of the Gag Reflex. [ Time Frame: followed from the end of anesthesia to gag reflex, up (...) to 2 hours ] The goal of the study is to determine whether caffeine speeds emergence from anesthesia. The time between terminating delivery of anesthetic and the subject starting to gag was measured. Anesthesia suppresses the gag reflex. Immediately after anesthetizing the test subject, a laryngeal mask airway (LMA) device was inserted into the test subject airway. After anesthesia was terminated and emergence from anesthesia was taking place, the gag reflex was re-established, and the LMA produced

2015 Clinical Trials

154. Laryngeal Tube vs Laryngeal Mask Airway

, dependant lividity) Pregnant women Conscious, intact gag reflex Known ingestion of caustic substances Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02607644 Locations Layout table for location information Singapore Singapore Civil Defence Force

2015 Clinical Trials

155. Comparison of dexmedetomidine-propofol versus fentanyl-propofol for insertion of laryngeal mask airway. (PubMed)

Comparison of dexmedetomidine-propofol versus fentanyl-propofol for insertion of laryngeal mask airway. Laryngeal mask airway (LMA) insertion requires anesthesia and suppression of airway reflexes. In search of an optimal drug, we compared dexmedetomidine and fentanyl, in combination with propofol for insertion of LMA.This study was a prospective double blind randomized study. Eighty patients of ASA class 1&2 were randomly divided into two groups of 40 each. Group D received dexmedetomidine 1 (...) mcg/kg and group F received fentanyl 1 mcg/kg intravenously (IV) over 2 minutes. For induction, propofol 2mg/kg was given IV and 90 seconds later LMA was inserted. We observed apnea time, heart rate, respiratory rate, non invasive blood pressure and oxygen saturation before induction, 30 seconds after induction, 1, 3, 5, 10 and 15 minutes after insertion of LMA. Patient's response to LMA insertion like coughing, gagging or any movement were noted and scored. Statistical analysis of data was done

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2015 Journal of anaesthesiology, clinical pharmacology

156. Discovering New Treatments for Asthma and COPD. A New Human Rhinvovirus for Human Challenge

healthy adults as determined by medical history, physical examination, serology (HIV and Hepatitis B and C) and clinical laboratory tests. Female subjects were required to provide of a history of reliable contraceptive practice. Exclusion Criteria:included; asthma, hypersensitivity to mercurials or chicken eggs, anatomic or neurologic abnormality impairing the gag reflex or contributing to aspiration, chronic nasopharyngeal complaints, abnormal electrocardiogram (ECG), febrile illness or significant

2015 Clinical Trials

157. Development of an Intranasal Proteosome Influenza Vaccine

: Young healthy adults as determined by medical history, physical examination, serology (HIV and Hepatitis B and C) and clinical laboratory tests. Female subjects were required to provide of a history of reliable contraceptive practice. Susceptibility to A/Panama/2007/1999 (H3N2) (a serum reciprocal HAI titre ≤10) was confirmed at screening. - Exclusion Criteria:included; asthma, hypersensitivity to mercurials or chicken eggs, anatomic or neurologic abnormality impairing the gag reflex or contributing

2015 Clinical Trials

158. Quaternary Ammonium Methacryloxy Silicate-containing Acrylic Resin

for eligibility information Ages Eligible for Study: 21 Years to 60 Years (Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: Yes Criteria Inclusion Criteria: Healthy individual with no history or presence of a systemic disease Absence of active caries or periodontal disease with pocket depths deeper than 4 mm Exclusion Criteria: Extensive gag reflex that precludes taking of an intraoral alginate impression Presence of cleft palate that precludes the wearing of a Hawley retainer Have been using

2015 Clinical Trials

159. The Manufacture of a New Wild-Type H3N2 Virus for the Human Viral Challenge Model

Adult Accepts Healthy Volunteers: Yes Criteria Inclusion Criteria: Young healthy adults as determined by medical history, physical examination, serology (HIV and Hepatitis B and C) and clinical laboratory tests. Female subjects were required to provide of a history of reliable contraceptive practice. Exclusion Criteria:included; asthma, hypersensitivity to mercurials or chicken eggs, anatomic or neurologic abnormality impairing the gag reflex or contributing to aspiration, * chronic nasopharyngeal

2015 Clinical Trials

160. Clinical Evaluation of the Response to Chest Physiotherapy in Children With Acute Bronchiolitis

of cough reflects and presence of laryngeal stridor is a contraindication to chest physiotherapy in general. Systematic presence of gag reflex as the aspiration of secretions and coughing caused nasobucales stimulate this reflex Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its ClinicalTrials.gov

2015 Clinical Trials

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