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Comparison of video and conventional laryngoscopes for simulated difficult emergency tracheal intubations in the presence of liquids in the airway

The presence of vomit, blood, or other foreign liquid materials in the upper airway is a major obstacle in difficult tracheal intubations (TIs) especially in prehospital care. However, the usefulness of video laryngoscopes (VLs) in these situations has not been investigated. The objective of this st...

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Autores principales: Suzuki, Kei, Kusunoki, Shinji, Sadamori, Takuma, Tanabe, Yuko, Itai, Junji, Shime, Nobuaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6641196/
https://www.ncbi.nlm.nih.gov/pubmed/31323067
http://dx.doi.org/10.1371/journal.pone.0220006
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author Suzuki, Kei
Kusunoki, Shinji
Sadamori, Takuma
Tanabe, Yuko
Itai, Junji
Shime, Nobuaki
author_facet Suzuki, Kei
Kusunoki, Shinji
Sadamori, Takuma
Tanabe, Yuko
Itai, Junji
Shime, Nobuaki
author_sort Suzuki, Kei
collection PubMed
description The presence of vomit, blood, or other foreign liquid materials in the upper airway is a major obstacle in difficult tracheal intubations (TIs) especially in prehospital care. However, the usefulness of video laryngoscopes (VLs) in these situations has not been investigated. The objective of this study was to compare the Airway Scope (AWS) and the Macintosh laryngoscope (ML) for their performance in TIs performed by emergency medical technicians (EMTs) using mannequin models with liquids in the airway. Rice gruel and mock blood were used to fill the upper airways of mannequins to create mock vomit and hematemesis models, respectively. TIs were performed by certified EMTs after visualizing the glottis using an AWS with an 18-Fr suction catheter and a ML with an 18-Fr suction catheter. TIs with AWS and ML were performed in random order in a comparative crossover trial. The TI success rate was evaluated based on the following: (a) the time taken from laryngoscope insertion into the oral cavity to glottis visualization, tracheal tube passage through the glottis, until the initiation of ventilation and (b) the subjective level of difficulty, which was assessed using a visual analog scale (VAS). TIs in vomiting and hematemesis scenarios were performed by 25 and 26 EMTs, respectively. The TI success rates for these scenarios were 100% with both AWS and ML. The median time required until successful ventilation was significantly shorter with AWS than with ML in both the vomiting (42 vs. 58 s) and hematemesis models (33 vs. 39 s), respectively. In the hematemesis scenarios, difficulty assessed using a VAS was lower with AWS than with ML (13 vs. 38 in median), respectively. Compared to the ML, the AWS was capable of faster and easier TIs, in a simulated model of liquid foreign material in the upper airway.
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spelling pubmed-66411962019-07-25 Comparison of video and conventional laryngoscopes for simulated difficult emergency tracheal intubations in the presence of liquids in the airway Suzuki, Kei Kusunoki, Shinji Sadamori, Takuma Tanabe, Yuko Itai, Junji Shime, Nobuaki PLoS One Research Article The presence of vomit, blood, or other foreign liquid materials in the upper airway is a major obstacle in difficult tracheal intubations (TIs) especially in prehospital care. However, the usefulness of video laryngoscopes (VLs) in these situations has not been investigated. The objective of this study was to compare the Airway Scope (AWS) and the Macintosh laryngoscope (ML) for their performance in TIs performed by emergency medical technicians (EMTs) using mannequin models with liquids in the airway. Rice gruel and mock blood were used to fill the upper airways of mannequins to create mock vomit and hematemesis models, respectively. TIs were performed by certified EMTs after visualizing the glottis using an AWS with an 18-Fr suction catheter and a ML with an 18-Fr suction catheter. TIs with AWS and ML were performed in random order in a comparative crossover trial. The TI success rate was evaluated based on the following: (a) the time taken from laryngoscope insertion into the oral cavity to glottis visualization, tracheal tube passage through the glottis, until the initiation of ventilation and (b) the subjective level of difficulty, which was assessed using a visual analog scale (VAS). TIs in vomiting and hematemesis scenarios were performed by 25 and 26 EMTs, respectively. The TI success rates for these scenarios were 100% with both AWS and ML. The median time required until successful ventilation was significantly shorter with AWS than with ML in both the vomiting (42 vs. 58 s) and hematemesis models (33 vs. 39 s), respectively. In the hematemesis scenarios, difficulty assessed using a VAS was lower with AWS than with ML (13 vs. 38 in median), respectively. Compared to the ML, the AWS was capable of faster and easier TIs, in a simulated model of liquid foreign material in the upper airway. Public Library of Science 2019-07-19 /pmc/articles/PMC6641196/ /pubmed/31323067 http://dx.doi.org/10.1371/journal.pone.0220006 Text en © 2019 Suzuki et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Suzuki, Kei
Kusunoki, Shinji
Sadamori, Takuma
Tanabe, Yuko
Itai, Junji
Shime, Nobuaki
Comparison of video and conventional laryngoscopes for simulated difficult emergency tracheal intubations in the presence of liquids in the airway
title Comparison of video and conventional laryngoscopes for simulated difficult emergency tracheal intubations in the presence of liquids in the airway
title_full Comparison of video and conventional laryngoscopes for simulated difficult emergency tracheal intubations in the presence of liquids in the airway
title_fullStr Comparison of video and conventional laryngoscopes for simulated difficult emergency tracheal intubations in the presence of liquids in the airway
title_full_unstemmed Comparison of video and conventional laryngoscopes for simulated difficult emergency tracheal intubations in the presence of liquids in the airway
title_short Comparison of video and conventional laryngoscopes for simulated difficult emergency tracheal intubations in the presence of liquids in the airway
title_sort comparison of video and conventional laryngoscopes for simulated difficult emergency tracheal intubations in the presence of liquids in the airway
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6641196/
https://www.ncbi.nlm.nih.gov/pubmed/31323067
http://dx.doi.org/10.1371/journal.pone.0220006
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