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

Bielski, Andrzej; Smereka, Jacek; Madziała, Marcin; Golik, Dawid; Szarpak, Łukasz

doi:10.1007/s00431-019-03345-4

Cited by 11 publications

(3 citation statements)

References 35 publications

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“…[20][21][22] However, the chest compression and LMA insertion time relationship remains controversial in that Bielski, et al and Lee, et al reported that there was no statistical association between chest compression and LMA insertion times, whereas Kohama, et al reported elongation of the LMA insertion times due to chest compression. [21][22][23] Inline bimanual cervical spinal motion restriction might render LMA insertion more difficult because the angle between the oral and pharyngeal axes becomes acute at the back of the tongue. 24 However, in the present study, inline bimanual cervical spinal motion restriction did not affect the first-pass success rates and insertion times.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Jaw-Thrust Maneuver and Standard Method for Airway Management with Laryngeal Mask Airway by Paramedics during Chest Compression: A Randomized, Crossover, Manikin Study

Özbek

Şancı

2022

Prehosp. Disaster med.

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Introduction: The first priority of the primary survey of trauma care is airway management. For patients who have a known or suspected cervical spine injury, using the jaw-thrust maneuver is critical. It was hypothesized that the jaw-thrust maneuver would ease the insertion of the laryngeal mask airway (LMA) by moving the tongue forward from the palate and posterior pharyngeal wall. Study Objectives: The aim of the study was to evaluate the effect of jaw-thrust maneuver on LMA insertion times of the paramedics with or without chest compression and with or without cervical stabilization in a manikin. Methods: Eleven experienced paramedics inserted LMA in jaw-thrust position and standard position in chest compression without cervical stabilization scenario, chest compression with cervical stabilization scenario, cervical stabilization without chest compression scenario, and the scenario where neither cervical stabilization nor chest compression were performed. The primary outcome of the study was the comparison of LMA insertion times for each method. The secondary outcome measures were first-pass success rates and the comparison of the difficulty level of each method. Results: During the LMA placement, performing the jaw-thrust maneuver instead of the standard method did not shorten the LMA insertion times. Adding chest compression and/or cervical stabilization did not complicate the LMA insertion. All of the LMA insertion attempts during the jaw-thrust maneuver and standard method were successful. Conclusion: The findings of this study suggest that LMA insertion might be attempted both during the jaw-thrust maneuver and standard position in patients with or without chest compression and with or without cervical stabilization.

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Section: Discussionmentioning

confidence: 99%

Comparison of Jaw-Thrust Maneuver and Standard Method for Airway Management with Laryngeal Mask Airway by Paramedics during Chest Compression: A Randomized, Crossover, Manikin Study

Özbek

Şancı

2022

Prehosp. Disaster med.

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“…To facilitate intubation, as demonstrated in this case, videolaryngoscopes may be an alternative [34–36], or the intubator can use a bougie stylet for difficult intubation. The second parameter that may reduce the effectiveness of intubation may be the fact that intubation is performed during resuscitation procedures, where chest compressions are implemented in parallel: moving the patient may make it difficult to visualize the vocal structures [27, 37].…”

Section: Discussionmentioning

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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“…Nowadays, the supraglottic airway devices (SADs) are widely used as an intermediate device between facemask and endotracheal tube for administration of general anaesthesia in short surgical procedures. The second generation SADs has achieved a solid and proven place as rescue device for managing difficult airways 1,2 and as conduit 3,4 to aid endotracheal intubation. These are also frequently used as resuscitation device to secure the airway especially in the out-of-hospital emergencies.…”

Section: Introductionmentioning

confidence: 99%

I-Gel and LMA classic in the hands of novice: A comparative study

Bhattacharjee¹,

Sarkar²,

Bhattacharyya³

et al. 2021

Asian J Med Sci

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Background: Supraglottic airway devices (SADs) such as LMA classic (cLMA), I-Gel, etc. are indispensable tool for the anaesthesiologists experienced in airway management. But studies evaluating the performance of these devices in the hands of unskilled personnel are scarce. Aims and Objective: To determine the procedure time and the proportion of patients having successful placement of I-gel and LMA classic by first-year Post Graduate Trainees (PGTs) of Anaesthesiology who tried insertion of those devices after a short training in mannequins without any hands-on training regarding placement of the devices in human. Materials and Methods: After getting Institute’s Ethics Committee’s approval for this interventional study, forty adult patients, posted for short surgical or gynaecological surgery, were randomly allocated in to two groups to have placement of either I-Gel (group ‘I’, n=20) or cLMA (group ‘C’, n=20) by first-year PGTs. The procedure time (Primary outcome) i.e. the time taken for successful placement of either device was determined and compared. A standard technique of anaesthesia was followed in every patient. Any adverse event such as sore throat, odynophagia, blood stain on the device, etc. was also recorded. Results: All patients were comparable with respect to demographic data and Mallampati scores. The mean procedure time (seconds) was considerably lower in I-Gel group compared with cLMA (63.3 ± 57.2 versus 163.0 ± 158.3, respectively, P value <0.001). The incidence of successful placement at first attempt was significantly higher for I-Gel group. The incidence of adverse events was comparable. Conclusion: Procedure time for I-Gel insertion is significantly shorter than with LMA Classic along with a higher success rate with first attempt for the former. I-Gel may be a better alternative as airway device for the unskilled anaesthesiologist.

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

Cited by 11 publications

References 35 publications

Comparison of Jaw-Thrust Maneuver and Standard Method for Airway Management with Laryngeal Mask Airway by Paramedics during Chest Compression: A Randomized, Crossover, Manikin Study

Comparison of Jaw-Thrust Maneuver and Standard Method for Airway Management with Laryngeal Mask Airway by Paramedics during Chest Compression: A Randomized, Crossover, Manikin Study

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

I-Gel and LMA classic in the hands of novice: A comparative study

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