Can the Face-to-Face Intubation Technique Be Used During Cardiopulmonary Resuscitation? A Prospective, Randomized, Crossover Manikin Trial

Madziala, Agnieszka; Evrın, Togay; Wieczorek, Wojciech; Kamińska, Halla; Nadolny, Klaudiusz; Ładny, Jerzy Robert; Szarpak, Łukasz

doi:10.5603/demj.2017.0033

Cited by 8 publications

(9 citation statements)

References 18 publications

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“…There are a number of limitations and problems related to endotracheal intubation [1, 7]. The main issue is the need of adequate experience [8–10].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Different Intubation Methods in Difficult Airways during Simulated Cardiopulmonary Resuscitation with Continuous Chest Compression: A Randomized Cross-Over Manikin Trial

Evrın

Smereka

Gorczyca

et al. 2019

Emergency Medicine International

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Introduction. Airway management is one of key elements of resuscitation. Endotracheal intubation is still considered the gold standard for airway management during resuscitation. Aim. The aim of the study was to compare success rates and intubation time of different endotracheal intubation methods during emergency intubation with difficult airways in the conditions of cardiopulmonary resuscitation in a standardized manikin model. Methods. The study was designed as a prospective, randomized, cross-over simulation study. It involved 46 paramedics with at least 5 years of experience in Emergency Medical Service. The participants performed endotracheal intubation under difficult airway conditions during continuous chest compression, implemented with the LUCAS3 chest compression system. Three methods of tracheal intubation were applied: (1) standard Macintosh laryngoscope without a bougie stylet; (2) standard laryngoscope and a standard bougie stylet; (3) standard laryngoscope and a new bougie stylet. Results. The overall intubation success rate was 100% in the standard bougie and new bougie groups and lower (86.9%) when no bougie stylet was used (P=0.028). The intubation success rate with the 1st attempt equalled 91.3% for the new bougie group, 73.9% for standard bougie, and only 23.9% in the no-bougie group. The median intubation time was shortest in the new bougie group, where it amounted to 29 s (interquartile range [IQR]: 25–38); the time equalled 38s (IQR:31–44.5) in the standard bougie group and 47.5s (IQR:36–58) in the no-bougie group. The ease of use was lowest in the no-bougie group (85, IQR:63–88), average in the standard bougie group (44, IQR:30–51), and highest in the new bougie stylet group (32, IQR:19–41). Conclusion. In this manikin-based study, paramedics were able to perform endotracheal intubation with higher efficacy and in a shorter time using the new bougie stylet as compared with the standard bougie stylet.

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“…There are a number of limitations and problems related to endotracheal intubation [1, 7]. The main issue is the need of adequate experience [8–10].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Different Intubation Methods in Difficult Airways during Simulated Cardiopulmonary Resuscitation with Continuous Chest Compression: A Randomized Cross-Over Manikin Trial

Evrın

Smereka

Gorczyca

et al. 2019

Emergency Medicine International

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“…For pediatric resuscitation, bag-mask ventilation remains the recommended first-line method for airway control and ventilation [23]. However, intubation is among the most important procedures related to prognosis in severe cases [24]. Endotracheal intubation is considered by many scientific societies the gold standard for airway management [9, 23].…”

Section: Introductionmentioning

confidence: 99%

Comparison of blind intubation with different supraglottic airway devices by inexperienced physicians in several airway scenarios: a manikin study

Bielski¹,

Smereka

Madziała

et al. 2019

Eur J Pediatr

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Endotracheal intubation is the gold standard for airway management. Supraglottic airway devices (SADs) are useful in airway abnormalities. SAD blind intubation enables airway management with better ventilation and a reduced risk of gastric content aspiration. The aim was to compare various SADs in blind intubation performed by inexperienced physicians in several pediatric airway scenarios. One hundred sixteen physicians with no previous experience with SAD performed blind endotracheal intubations with (1) iGEL, (2) Air-Q intubating laryngeal airway, and (3) Ambu AuraGain disposable laryngeal mask in a pediatric manikin in three airway scenarios: (A) normal airway without chest compressions, (B) normal airway with continuous chest compressions with the CORPULS CPR system, and (C) difficult airway with continuous chest compressions with the CORPULS CPR system. Intubation tube with 5.0 internal diameter was used for all blind intubation attempts. First intubation success rate, median time to SAD placement, time to endotracheal intubation with SAD, and ease to perform the intubation were investigated in this study. All these parameters were better or non-inferior for iGEL in all investigated scenarios. Conclusion : Our manikin study demonstrated that iGEL was the most effective device for blind intubation by inexperienced physicians in different pediatric airway scenarios. What is Known: • For pediatric resuscitation, bag-mask ventilation is the first-line method for airway control and ventilation. • Endotracheal intubation is considered by many scientific societies the gold standard for airway management. • Supraglottic airway devices are particularly useful when bag-mask ventilation is difficult or impossible but can be also used for blind intubation. What is New: • The iGEL laryngeal mask turns out the most effective device for blind intubation by inexperienced physicians in different pediatric airway scenarios. • It may be a reasonable first emergency blind intubation technique for inexperienced physicians in pediatric patients in normal airway with and without continuous chest compressions, as well as in difficult airway with continuous chest compressions.

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“…[2], [6] Nevertheless, it seems that a video laryngoscope is better suited for this technique, achieving higher effectiveness, shorter intubations time and conveniences for anesthetist. [7] Some authors report, that inverse intubation can be performed by one person successfully and does not demand an assistant. [8], [9] The anesthetist (standing on the left side of the patient) can hold a video laryngoscope with his right hand and insert the tube with the left one.…”

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confidence: 99%

Face-to-Face Intubation in Adults: A Comparison of Video Laryngoscopes Kingvision and Airtraq for Intubation in Morbidly Obese Patients – Series of Cases.

Nowak-Tim

Gaszyński

2020

Preprint

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Backgroud: Traditional endotracheal intubation demands unlimited access to the patient and possibility to stand behind his head. However, in case of difficult conditions in emergency settings we can use an alternative method. Face-to-face intubation can be performed in patients in semi-erect position, prone position and in the situation of difficult access to the head. Method: After obtaining an approval from the Local Ethics Committee Nr RNN/62/20/KE and written informed consent from the patients, we performed 8 procedures of face-to-face intubations in 8 patients who were scheduled for planned operations, using Kingvision and Airtraq video laryngoscopes chosen in random way. Results: The intubation time was comparable between devices: 9.25 ±2.217 s vs 8 ±2.3 s (p=0.2322) in Kingvision and Airtraq videolaryngscopes respectively. Both devices appeared to deliver an optimal view of the larynx inlet and enable the operator to intubate with face-to-face method without any complications. Conclusions: There were no significant difference in effectiveness between Kingvision and Airtraq video laryngoscopes during face-to-face intubation. Utilisation of these devices allowed the anesthetist to stand in front of the patient during endotracheal intubation and ensured an excellent view of larynx entrance. We assume that in case of difficult access to the patient’s head or untypical position, the usage of examined video laryngoscopes, should be considered.

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Can the Face-to-Face Intubation Technique Be Used During Cardiopulmonary Resuscitation? A Prospective, Randomized, Crossover Manikin Trial

Cited by 8 publications

References 18 publications

Comparison of Different Intubation Methods in Difficult Airways during Simulated Cardiopulmonary Resuscitation with Continuous Chest Compression: A Randomized Cross-Over Manikin Trial

Comparison of Different Intubation Methods in Difficult Airways during Simulated Cardiopulmonary Resuscitation with Continuous Chest Compression: A Randomized Cross-Over Manikin Trial

Comparison of blind intubation with different supraglottic airway devices by inexperienced physicians in several airway scenarios: a manikin study

Face-to-Face Intubation in Adults: A Comparison of Video Laryngoscopes Kingvision and Airtraq for Intubation in Morbidly Obese Patients – Series of Cases.

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