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A comparison of airway management devices in simulated entrapment-trauma: a prospective manikin study
INTRODUCTION: In the patient entrapped after a motor vehicle collision (MVC), advanced airway management may need to be performed before extrication. The aim of this study was to compare four airway management devices utilized by paramedics in a simulated entrapped patient. METHODS: Twenty-six param...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer Berlin Heidelberg
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615147/ https://www.ncbi.nlm.nih.gov/pubmed/31286862 http://dx.doi.org/10.1186/s12245-019-0233-z |
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author | Pap, Robin van Loggerenberg, Charl |
author_facet | Pap, Robin van Loggerenberg, Charl |
author_sort | Pap, Robin |
collection | PubMed |
description | INTRODUCTION: In the patient entrapped after a motor vehicle collision (MVC), advanced airway management may need to be performed before extrication. The aim of this study was to compare four airway management devices utilized by paramedics in a simulated entrapped patient. METHODS: Twenty-six paramedics performed advanced airway management on a manikin seated in the driver’s seat (right side) of a car. Access was through the opened door only. The airway devices were the Macintosh laryngoscope and the Airtraq optical laryngoscope to facilitate the endotracheal intubation (ETI), the laryngeal mask airway (LMA) Supreme and the laryngeal tube (LT). Time to first successful ventilation and number of attempts required for successful placement were measured. Following each placement, participants rated the degree of difficulty. For ETI, participants ranked the achieved glottic view using Cormack-Lehane grades (CLG). Finally, participants were asked which airway management device they preferred. RESULTS: The LMA Supreme had the shortest mean time to first successful ventilation (16.7 s, CI [0.95] 14.9–18.6). Insertion of the LMA Supreme and ETI with the Macintosh laryngoscope had 100% first-attempt success. The LMA Supreme was rated least difficult to insert (mean score 1.7/10 (CI [0.95] 1.2–2.1)). Compared to the Macintosh, the Airtraq laryngoscope facilitated superior laryngoscopy (CLG I view 46.2% and 80.8%, respectively). Most participants (10/26; 38%) chose the Macintosh laryngoscope as their preferred technique, followed closely by the LMA Supreme (9/26; 35%). CONCLUSION: The LMA Supreme took the least amount of time and was the easiest to be inserted. Extraglottic airway devices may be beneficial alternative airway management devices to be considered by paramedics in the entrapped patient. Endotracheal intubation using the Macintosh laryngoscope was performed competently by participating paramedics. The Airtraq enabled superior laryngoscopy but resulted in poorer first-pass success rate. |
format | Online Article Text |
id | pubmed-6615147 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-66151472019-07-22 A comparison of airway management devices in simulated entrapment-trauma: a prospective manikin study Pap, Robin van Loggerenberg, Charl Int J Emerg Med Original Research INTRODUCTION: In the patient entrapped after a motor vehicle collision (MVC), advanced airway management may need to be performed before extrication. The aim of this study was to compare four airway management devices utilized by paramedics in a simulated entrapped patient. METHODS: Twenty-six paramedics performed advanced airway management on a manikin seated in the driver’s seat (right side) of a car. Access was through the opened door only. The airway devices were the Macintosh laryngoscope and the Airtraq optical laryngoscope to facilitate the endotracheal intubation (ETI), the laryngeal mask airway (LMA) Supreme and the laryngeal tube (LT). Time to first successful ventilation and number of attempts required for successful placement were measured. Following each placement, participants rated the degree of difficulty. For ETI, participants ranked the achieved glottic view using Cormack-Lehane grades (CLG). Finally, participants were asked which airway management device they preferred. RESULTS: The LMA Supreme had the shortest mean time to first successful ventilation (16.7 s, CI [0.95] 14.9–18.6). Insertion of the LMA Supreme and ETI with the Macintosh laryngoscope had 100% first-attempt success. The LMA Supreme was rated least difficult to insert (mean score 1.7/10 (CI [0.95] 1.2–2.1)). Compared to the Macintosh, the Airtraq laryngoscope facilitated superior laryngoscopy (CLG I view 46.2% and 80.8%, respectively). Most participants (10/26; 38%) chose the Macintosh laryngoscope as their preferred technique, followed closely by the LMA Supreme (9/26; 35%). CONCLUSION: The LMA Supreme took the least amount of time and was the easiest to be inserted. Extraglottic airway devices may be beneficial alternative airway management devices to be considered by paramedics in the entrapped patient. Endotracheal intubation using the Macintosh laryngoscope was performed competently by participating paramedics. The Airtraq enabled superior laryngoscopy but resulted in poorer first-pass success rate. Springer Berlin Heidelberg 2019-07-08 /pmc/articles/PMC6615147/ /pubmed/31286862 http://dx.doi.org/10.1186/s12245-019-0233-z Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Research Pap, Robin van Loggerenberg, Charl A comparison of airway management devices in simulated entrapment-trauma: a prospective manikin study |
title | A comparison of airway management devices in simulated entrapment-trauma: a prospective manikin study |
title_full | A comparison of airway management devices in simulated entrapment-trauma: a prospective manikin study |
title_fullStr | A comparison of airway management devices in simulated entrapment-trauma: a prospective manikin study |
title_full_unstemmed | A comparison of airway management devices in simulated entrapment-trauma: a prospective manikin study |
title_short | A comparison of airway management devices in simulated entrapment-trauma: a prospective manikin study |
title_sort | comparison of airway management devices in simulated entrapment-trauma: a prospective manikin study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615147/ https://www.ncbi.nlm.nih.gov/pubmed/31286862 http://dx.doi.org/10.1186/s12245-019-0233-z |
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