2021
Improving Capnography Use for Critically Ill Emergency Patients: An Implementation Study
Shah R, Streat DA, Auerbach M, Shabanova V, Langhan ML. Improving Capnography Use for Critically Ill Emergency Patients: An Implementation Study. Journal Of Patient Safety 2021, 18: e26-e32. PMID: 32175968, PMCID: PMC8719501, DOI: 10.1097/pts.0000000000000683.Peer-Reviewed Original Research
2018
End-Tidal Carbon Dioxide Use for Tracheal Intubation
Langhan ML, Emerson BL, Nett S, Pinto M, Harwayne-Gidansky I, Rehder KJ, Krawiec C, Meyer K, Giuliano JS, Owen EB, Tarquinio KM, Sanders RC, Shepherd M, Bysani GK, Shenoi AN, Napolitano N, Gangadharan S, Parsons SJ, Simon DW, Nadkarni VM, Nishisaki A. End-Tidal Carbon Dioxide Use for Tracheal Intubation. Pediatric Critical Care Medicine 2018, 19: 98-105. PMID: 29140968, DOI: 10.1097/pcc.0000000000001372.Peer-Reviewed Original ResearchConceptsCapnography useTracheal intubationCardiac arrestEmergency departmentEsophageal intubationOxygen desaturationWaveform capnographyAdverse tracheal intubation-associated eventsMulticenter retrospective cohort studyNational Emergency Airway RegistryTracheal intubation-associated eventsEnd-tidal carbon dioxide measurementPrimary tracheal intubationsRetrospective cohort studyUse of capnographyTracheal intubation procedureQuality improvement initiativesAirway RegistryCohort studyProvider characteristicsSafety outcomesIntubationIntubation procedureCapnographyImprovement initiatives
2017
Use of Capnography to Optimize Procedural Sedation in the Emergency Department Pediatric Population
Bovino L, Brainard C, Beaumier K, Concetti V, Lefurge N, Mittelstadt E, Wilson T, Langhan ML. Use of Capnography to Optimize Procedural Sedation in the Emergency Department Pediatric Population. Journal Of Emergency Nursing 2017, 44: 110-116. PMID: 29169819, DOI: 10.1016/j.jen.2017.10.016.Peer-Reviewed Original ResearchConceptsUse of capnographyProcedural sedationWaveform capnographyRespiratory rateNursing practiceEmergency nursing practicePediatric procedural sedationGood nursing practicePatient's respiratory ratePediatric populationAbnormal ventilationPatient outcomesObservational studyEmergency nursesTidal volumePulse oximetryLarger studyPhysical assessmentCapnographySedationVentilationAnalgesiaCarbon dioxide levelsOximetryNursesCan Providers Use Clinical Skills to Assess the Adequacy of Ventilation in Children During Bag-Valve Mask Ventilation?
Becker HJ, Langhan ML. Can Providers Use Clinical Skills to Assess the Adequacy of Ventilation in Children During Bag-Valve Mask Ventilation? Pediatric Emergency Care 2017, Publish Ahead of Print: 1. PMID: 29084068, DOI: 10.1097/pec.0000000000001314.Peer-Reviewed Original ResearchMeSH KeywordsCapnographyChildChild, PreschoolClinical CompetenceHumansMonitoring, PhysiologicRespiration, ArtificialConceptsBag-valve mask ventilationBVM ventilationPediatric patientsAbnormal ventilationMask ventilationNineteen providersNormal ventilationCapnography dataInduction of anesthesiaTotal mean durationAdequacy of ventilationClinical skillsCapnography monitoringRespiratory supportMedian ageNonintubated patientsElective surgeryMean durationHealthy childrenMinute ventilationClinical assessmentPatientsInappropriate ventilationStandard monitoringCapnography valuesCapnography Use During Intubation and Cardiopulmonary Resuscitation in the Pediatric Emergency Department
Bullock A, Dodington JM, Donoghue AJ, Langhan ML. Capnography Use During Intubation and Cardiopulmonary Resuscitation in the Pediatric Emergency Department. Pediatric Emergency Care 2017, 33: 457-461. PMID: 27455341, PMCID: PMC5259553, DOI: 10.1097/pec.0000000000000813.Peer-Reviewed Original ResearchConceptsCapnography useEmergency departmentHospital emergency departmentCardiopulmonary resuscitationSpontaneous circulationAHA recommendationsAcademic children's hospital emergency departmentChildren's hospital emergency departmentAmerican Heart Association guidelinesImplementation of capnographyIll pediatric patientsHeart Association guidelinesRetrospective chart reviewUse of capnographyPediatric emergency departmentChart reviewAdverse eventsPatient characteristicsPediatric patientsIntubated patientsEndotracheal intubationTraumatic causesAssociation guidelinesIll childrenPatientsThe impact of capnography monitoring among children and adolescents in the postanesthesia care unit: a randomized controlled trial
Langhan ML, Li F, Lichtor JL. The impact of capnography monitoring among children and adolescents in the postanesthesia care unit: a randomized controlled trial. Pediatric Anesthesia 2017, 27: 385-393. PMID: 28177565, DOI: 10.1111/pan.13077.Peer-Reviewed Original ResearchConceptsPostanesthesia care unitPulse oximetryRespiratory depressionAdverse eventsCare unitRespiratory eventsControl groupPediatric postanesthesia care unitAddition of capnographyRates of hypoxemiaAdverse respiratory eventsStaff interventionsPACU staffOxygen desaturationCapnography monitoringElective surgerySupplemental oxygenGeneral anesthesiaHealthy childrenIntervention groupPatient interventionsAbsence of interventionCapnography monitorStandard monitoringVital signs
2016
Respiratory depression detected by capnography among children in the postanesthesia care unit: a cross‐sectional study
Langhan ML, Li FY, Lichtor JL. Respiratory depression detected by capnography among children in the postanesthesia care unit: a cross‐sectional study. Pediatric Anesthesia 2016, 26: 1010-1017. PMID: 27396979, DOI: 10.1111/pan.12965.Peer-Reviewed Original ResearchConceptsPostanesthesia care unitCross-sectional studyRespiratory depressionPulse oximetryOxygen desaturationCare unitSupplemental oxygenTertiary care hospitalNarcotic medicationsCapnography monitoringCare hospitalRoutine careHealthy childrenMedication administrationPatient interventionsOutcome measuresHypoventilationApneaCapnography monitorPatientsVital signsCapnographyPatient safetyOximetryIntervention
2015
A qualitative evaluation of capnography use in paediatric sedation: perceptions, practice and barriers
Iyer NS, Koziel JR, Langhan ML. A qualitative evaluation of capnography use in paediatric sedation: perceptions, practice and barriers. Journal Of Clinical Nursing 2015, 24: 2231-2238. PMID: 25926380, DOI: 10.1111/jocn.12848.Peer-Reviewed Original ResearchConceptsPediatric emergency departmentUse of capnographyEmergency departmentCapnography useProcedural sedationAdequacy of ventilationMonitoring of childrenAdverse eventsHead traumaPediatric populationMental statusPediatric sedationLack of comfortModifiable barriersSedationCapnographyQualitative exploratory studyMost participantsLack of availabilityNursesPhysiciansVentilationDepartmentParticipantsAdditional education
2014
A randomized controlled trial of capnography during sedation in a pediatric emergency setting
Langhan ML, Shabanova V, Li FY, Bernstein SL, Shapiro ED. A randomized controlled trial of capnography during sedation in a pediatric emergency setting. The American Journal Of Emergency Medicine 2014, 33: 25-30. PMID: 25445871, PMCID: PMC4272647, DOI: 10.1016/j.ajem.2014.09.050.Peer-Reviewed Original ResearchConceptsEpisodes of hypoventilationOxygen desaturationIntervention groupStandard monitoringPediatric emergency department patientsEmergency department patientsSedation of childrenPediatric emergency departmentPediatric emergency settingRates of interventionFrequency of interventionsRespiratory depressionPrimary outcomeDepartment patientsEmergency departmentProcedural sedationEmergency settingHigher oddsHypoventilationCapnography monitorControl groupSedationStandard modalityTimely interventionCapnographyExperiences with capnography in acute care settings: A mixed-methods analysis of clinical staff
Langhan ML, Kurtz JC, Schaeffer P, Asnes AG, Riera A. Experiences with capnography in acute care settings: A mixed-methods analysis of clinical staff. Journal Of Critical Care 2014, 29: 1035-1040. PMID: 25129575, PMCID: PMC4194255, DOI: 10.1016/j.jcrc.2014.06.021.Peer-Reviewed Original ResearchConceptsUse of capnographyAcute care areasCare unitCare areasPatient careIntensive care unitAcute care settingAcute care unitsFuture implementation strategiesCapnography useEmergency departmentClinical guidelinesCare settingsNineteen providersClinical staffCapnographyVariable knowledgeConstant comparative methodPurposeful sampleCareVaried responsivenessImplementation strategiesMixed-method analysisHospitalIterative data analysis
2013
Acute Alcohol Intoxication in Adolescents: Frequency of Respiratory Depression
Langhan ML. Acute Alcohol Intoxication in Adolescents: Frequency of Respiratory Depression. Journal Of Emergency Medicine 2013, 44: 1063-1069. PMID: 23485262, DOI: 10.1016/j.jemermed.2012.11.041.Peer-Reviewed Original ResearchConceptsAcute alcohol intoxicationRespiratory depressionAlcohol intoxicationAlcohol levelsProspective observational pilot studyEpisodes of hypoventilationIncidence of hypoventilationMean alcohol levelsObservational pilot studySerious adverse effectsPercent of subjectsHours of intoxicationYears of ageEffects of alcoholOxygen desaturationPatients 14Younger patientsHypoventilationLow dosesSecondary objectiveVital signsAdult counterpartsPatient safetyPilot studyIntoxication
2012
Improving Detection by Pediatric Residents of Endotracheal Tube Dislodgement with Capnography: A Randomized Controlled Trial
Langhan ML, Auerbach M, Smith AN, Chen L. Improving Detection by Pediatric Residents of Endotracheal Tube Dislodgement with Capnography: A Randomized Controlled Trial. The Journal Of Pediatrics 2012, 160: 1009-1014.e1. PMID: 22244462, DOI: 10.1016/j.jpeds.2011.12.012.Peer-Reviewed Original ResearchConceptsPediatric residentsEndotracheal tubeIntervention groupPulse oximetryStandard monitoringPercent of subjectsEndotracheal tube dislodgementSecondary outcomesControlled TrialsPrimary outcomeIntubated patientsTube dislodgementClinical experienceControl groupCapnographyPatient safetyDislodgementDidactic sessionsPostgraduate yearPatient simulatorOximetrySubjectsOutcomesGroupResidents
2011
A Randomized Controlled Trial of Capnography in the Correction of Simulated Endotracheal Tube Dislodgement
Langhan ML, Ching K, Northrup V, Alletag M, Kadia P, Santucci K, Chen L. A Randomized Controlled Trial of Capnography in the Correction of Simulated Endotracheal Tube Dislodgement. Academic Emergency Medicine 2011, 18: 590-596. PMID: 21676056, PMCID: PMC3117244, DOI: 10.1111/j.1553-2712.2011.01090.x.Peer-Reviewed Original ResearchConceptsEndotracheal tubePulse oximetryStandard monitoringAddition of capnographyStandard monitoring groupPercent of subjectsEndotracheal tube dislodgementLife-threatening consequencesCapnography groupIntubated babiesSecondary outcomesPrimary outcomeAirway problemsControlled TrialsIntubated patientsMedian timeTube dislodgementPhysical examinationInterfacility transportPrehospital providersCapnographyPatientsDislodgementOximetryMonitoring groupDetection of Hypoventilation by Capnography and Its Association With Hypoxia in Children Undergoing Sedation With Ketamine
Langhan ML, Chen L, Marshall C, Santucci KA. Detection of Hypoventilation by Capnography and Its Association With Hypoxia in Children Undergoing Sedation With Ketamine. Pediatric Emergency Care 2011, 27: 394-397. PMID: 21494162, DOI: 10.1097/pec.0b013e318217b538.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAnesthetics, DissociativeCapnographyCarbon DioxideChildChild, PreschoolConscious SedationDiagnosis, DifferentialFemaleFollow-Up StudiesHumansHypoventilationHypoxiaInfantInjections, IntravenousIntensive Care Units, PediatricKetamineMaleProspective StudiesReproducibility of ResultsYoung AdultConceptsPercent of subjectsPulse oximetryRespiratory ratePersistent decreaseEnd-tidal carbon dioxide levelsDetection of hypoventilationPediatric emergency departmentStandard monitoring practicesIntravenous ketamineEmergency departmentTidal volumeHeart rateSedationHypoventilationTransient decreaseKetamineOximetryCapnographyHypoxiaFurther studiesMidazolamChildrenFrequency of hypoxiaRoutine monitoringSubjectsAvailability and clinical utilization of capnography in the prehospital setting.
Langhan M. Availability and clinical utilization of capnography in the prehospital setting. Connecticut Medicine 2011, 75: 197-201. PMID: 21560724.Peer-Reviewed Original ResearchConceptsPrehospital providersMonitoring of patientsMeasures of ventilationIll patientsNonintubated patientsEndotracheal intubationPrehospital settingCardiopulmonary resuscitationClinical scenariosClinical situationsWeb-based surveyCapnographyClinical utilizationPatientsMajority of respondentsVentilationObjective measuresProvidersIntubationAirwayResuscitationPerfusionCare
2008
Continuous end-tidal carbon dioxide monitoring in pediatric intensive care units
Langhan M. Continuous end-tidal carbon dioxide monitoring in pediatric intensive care units. Journal Of Critical Care 2008, 24: 227-230. PMID: 19327292, DOI: 10.1016/j.jcrc.2008.04.004.Peer-Reviewed Original ResearchConceptsPediatric intensive care unitIntensive care unitEnd-tidal carbon dioxide monitoringCare unitCarbon dioxide monitoringPercent of respondentsIntubated patientsPercent of directorsEndotracheal tube confirmationIll pediatric patientsContinuous End-Tidal Carbon Dioxide MonitoringAcid-base disturbancesCritical care fellowship programsTube confirmationNonintubated patientsPediatric patientsModerate sedationCardiopulmonary resuscitationCommon reasonPatientsClinical situationsWeb-based surveyClinical applicationUtilization patternsLack of availabilityCurrent Utilization of Continuous End-Tidal Carbon Dioxide Monitoring in Pediatric Emergency Departments
Langhan ML, Chen L. Current Utilization of Continuous End-Tidal Carbon Dioxide Monitoring in Pediatric Emergency Departments. Pediatric Emergency Care 2008, 24: 211-213. PMID: 18431217, DOI: 10.1097/pec.0b013e31816a8d31.Peer-Reviewed Original ResearchConceptsPediatric emergency departmentEnd-tidal carbon dioxide monitoringETCO2 monitoringEmergency departmentPercent of respondentsCarbon dioxide monitoringEndotracheal tube confirmationContinuous ETCO2 monitoringContinuous End-Tidal Carbon Dioxide MonitoringPediatric emergency medicine fellowship programsAcid-base disturbancesTube confirmationIntubated patientsNonintubated patientsModerate sedationEmergency settingCommon reasonWeb-based survey