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Intubation performance using different laryngoscopes while wearing chemical protective equipment: a manikin study
OBJECTIVES: This study aimed to compare visualisation of the vocal cords and performance of intubation by anaesthetists using four different laryngoscopes while wearing full chemical protective equipment. SETTING: Medical simulation center of a university hospital, department of anaesthesiology. PAR...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800129/ https://www.ncbi.nlm.nih.gov/pubmed/27008688 http://dx.doi.org/10.1136/bmjopen-2015-010250 |
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author | Schröder, H Zoremba, N Rossaint, R Deusser, K Stoppe, C Coburn, M Rieg, A Schälte, G |
author_facet | Schröder, H Zoremba, N Rossaint, R Deusser, K Stoppe, C Coburn, M Rieg, A Schälte, G |
author_sort | Schröder, H |
collection | PubMed |
description | OBJECTIVES: This study aimed to compare visualisation of the vocal cords and performance of intubation by anaesthetists using four different laryngoscopes while wearing full chemical protective equipment. SETTING: Medical simulation center of a university hospital, department of anaesthesiology. PARTICIPANTS: 42 anaesthetists (15 females and 27 males) completed the trial. The participants were grouped according to their professional education as anaesthesiology residents with experience of <2 years or <5 years, or as anaesthesiology specialists with experience of >5 years. INTERVENTIONS: In a manikin scenario, participants performed endotracheal intubations with four different direct and indirect laryngoscopes (Macintosh (MAC), Airtraq (ATQ), Glidescope (GLS) and AP Advance (APA)), while wearing chemical protective gear, including a body suit, rubber gloves, a fire helmet and breathing apparatus. PRIMARY AND SECONDARY OUTCOME MEASURES: With respect to the manikin, setting time to complete ‘endotracheal intubation’ was defined as primary end point. Glottis visualisation (according to the Cormack-Lehane score (CLS) and impairments caused by the protective equipment, were defined as secondary outcome measures. RESULTS: The times to tracheal intubation were calculated using the MAC (31.4 s; 95% CI 26.6 to 36.8), ATQ (37.1 s; 95% CI 28.3 to 45.9), GLS (35.4 s; 95% CI 28.7 to 42.1) and APA (23.6 s; 95% CI 19.1 to 28.1), respectively. Intubation with the APA was significantly faster than with all the other devices examined among the total study population (p<0.05). A significant improvement in visualisation of the vocal cords was reported for the APA compared with the GLS. CONCLUSIONS: Despite the restrictions caused by the equipment, the anaesthetists intubated the manikin successfully within adequate time. The APA outperformed the other devices in the time to intubation, and it has been evaluated as an easily manageable device for anaesthetists with varying degrees of experience (low to high), providing good visualisation in scenarios that require the use of chemical protective equipment. |
format | Online Article Text |
id | pubmed-4800129 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-48001292016-03-29 Intubation performance using different laryngoscopes while wearing chemical protective equipment: a manikin study Schröder, H Zoremba, N Rossaint, R Deusser, K Stoppe, C Coburn, M Rieg, A Schälte, G BMJ Open Emergency Medicine OBJECTIVES: This study aimed to compare visualisation of the vocal cords and performance of intubation by anaesthetists using four different laryngoscopes while wearing full chemical protective equipment. SETTING: Medical simulation center of a university hospital, department of anaesthesiology. PARTICIPANTS: 42 anaesthetists (15 females and 27 males) completed the trial. The participants were grouped according to their professional education as anaesthesiology residents with experience of <2 years or <5 years, or as anaesthesiology specialists with experience of >5 years. INTERVENTIONS: In a manikin scenario, participants performed endotracheal intubations with four different direct and indirect laryngoscopes (Macintosh (MAC), Airtraq (ATQ), Glidescope (GLS) and AP Advance (APA)), while wearing chemical protective gear, including a body suit, rubber gloves, a fire helmet and breathing apparatus. PRIMARY AND SECONDARY OUTCOME MEASURES: With respect to the manikin, setting time to complete ‘endotracheal intubation’ was defined as primary end point. Glottis visualisation (according to the Cormack-Lehane score (CLS) and impairments caused by the protective equipment, were defined as secondary outcome measures. RESULTS: The times to tracheal intubation were calculated using the MAC (31.4 s; 95% CI 26.6 to 36.8), ATQ (37.1 s; 95% CI 28.3 to 45.9), GLS (35.4 s; 95% CI 28.7 to 42.1) and APA (23.6 s; 95% CI 19.1 to 28.1), respectively. Intubation with the APA was significantly faster than with all the other devices examined among the total study population (p<0.05). A significant improvement in visualisation of the vocal cords was reported for the APA compared with the GLS. CONCLUSIONS: Despite the restrictions caused by the equipment, the anaesthetists intubated the manikin successfully within adequate time. The APA outperformed the other devices in the time to intubation, and it has been evaluated as an easily manageable device for anaesthetists with varying degrees of experience (low to high), providing good visualisation in scenarios that require the use of chemical protective equipment. BMJ Publishing Group 2016-03-15 /pmc/articles/PMC4800129/ /pubmed/27008688 http://dx.doi.org/10.1136/bmjopen-2015-010250 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Emergency Medicine Schröder, H Zoremba, N Rossaint, R Deusser, K Stoppe, C Coburn, M Rieg, A Schälte, G Intubation performance using different laryngoscopes while wearing chemical protective equipment: a manikin study |
title | Intubation performance using different laryngoscopes while wearing chemical protective equipment: a manikin study |
title_full | Intubation performance using different laryngoscopes while wearing chemical protective equipment: a manikin study |
title_fullStr | Intubation performance using different laryngoscopes while wearing chemical protective equipment: a manikin study |
title_full_unstemmed | Intubation performance using different laryngoscopes while wearing chemical protective equipment: a manikin study |
title_short | Intubation performance using different laryngoscopes while wearing chemical protective equipment: a manikin study |
title_sort | intubation performance using different laryngoscopes while wearing chemical protective equipment: a manikin study |
topic | Emergency Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800129/ https://www.ncbi.nlm.nih.gov/pubmed/27008688 http://dx.doi.org/10.1136/bmjopen-2015-010250 |
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