Intubation of a Paediatric Manikin in Tongue Oedema and Face-to-Face Simulations by Novice Personnel: a Comparison of Glidescope, Airtraq and Direct Laryngoscopy

Abstract

Amaç: Glidescope ve Airtraq entübasyonu kolaylaştırmak ve havayolu anatomisini öğretmek için geliştirilmişlerdir. Biz, bu havayolu araçlarının deneyimsiz personelce kullanımlarındaki etkinliklerini normal havayolu, dil ödemi ve yüz yüze entübasyon modellerinde değerlendirmeyi amaçladık.Yöntemler: Lokal İnsan Araştırmaları Etik Kurulu onayı alın-dıktan sonra tıp fakültesi 3. sınıf başlangıcında olan 36 öğrenci çalışmaya dahil edildi. Glidescope ve Airtraq ile pediyatrik maket üzerinde üç havayolu modelinde (sırasıyla); normal havayolu, dil ödemi ve yüz yüze entübasyon yapmışlardır. Bulgular:Yerleştirme ve entübasyon süreleri gruplar arasında benzer olmasına rağmen, Glidescope'un entübasyon başarı oranı normal havayolunda (%100 ve %67) ve dil ödeminde (%89 ve 50%) ile Airtraq'den fazladır (p=0,008 ve p=0,009). Maket üzerinde yüz yüze entübasyon başarı oranı gruplar arasında benzerdi (%50) (p=0,7). Manevra gereksinimi Glidescope grubunda normal ve dil ödemi modellerinde daha azdı (p=0,02 ve 0,002). Ek olarak, Glidescope ile özofagus entübasyonu normal ve dil ödeminde azdı (p=0,03 ve p<0,001).Sonuç: Deneyimsiz personel Glidescope ile Airtraq'e kıyasla trakeayı daha kolay entübe etmişlerdir. Glidescope ile entübasyon, normal ve dil ödemi modellerinde Airtraq'ten üstündür. Yüz yüze entübasyon başarı oranları hem Glidescope hem de Airtraq grubunda düşük bulunmuştur. Anahtar kelimeler: Laringoskoplar, havayolu yönetimi, entübas-yonObjective: Glidescope and Airtraq were designed for facilitating intubation and for teaching regarding the airway anatomy. We aimed to evaluate their efficacy in normal airway, tongue oedema and face-toface orotracheal intubation models when used by novice personnel. Methods:After the local human research ethics committee approval, 36 medical students who were in the beginning of their third year were enrolled in this study. After watching a video regarding intubation using one of these devices, the students intubated a paediatric manikin with a Glidescope or Airtraq via the normal airway, tongue oedema and face-to-face approach. Results:Although the insertion and intubation times were similar among the groups, the intubation success rate of the Glidescope was higher in the normal airway (100% vs 67%) and tongue oedema (89% vs. 50%) compared with the Airtraq (p=0.008 and p=0.009). The success rates with the paediatric manikin by the face-to-face approach were similar among the groups (50%) (p=0.7). The need for manoeuvres in the Glidescope was lower in the normal and tongue oedema models (p=0.02 and p=0.002). In addition, oesophageal intubation was low in the control and tongue oedema models with the Glidescope (p=0.03 and p<0.001). Conclusion:Novice personnel could more easily intubate the trachea with the Glidescope than with the Airtraq. Intubation with the Glidescope was superior to that with the Airtraq in the normal and tongue oedema models. The face-to-face intubation success rates were both low with both the Glidescope and Airtraq groups. Keywords: Laryngoscopes, airway management, int...

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

“…Higher success rates and shorter times of intubation by paramedics may be caused by the fact that in Polish conditions paramedics learn to perform endotracheal intubation during their studies. Arslan et al [19] presented data that the usage of video laryngoscopy may increase success rates of face-to-face endotracheal intubation. In his study, 3rd year medical students performed intubation utilizing the GlideScope and AirTraq with success rate of 100% and 67%, respectively.…”