Intubation of a Pediatric Manikin in Tongue Edema and Face-to-Face Simulations by Emergency Medical Staff: A Comparison of the Glidescope, Airtraq and Direct Laryngoscopy

Abstract

78rauma victims often need to be intubated at the scene of the trauma. Such intubation is occasionally difficult due to limited access to the patient, cervical spine injury or some factor that makes it difficult to Intubation of a Pediatric Manikin in TongueEdema and Face-to-Face Simulations by Emergency Medical Staff: A Comparison of the Glidescope, Airtraq and Direct Laryngoscopy A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Trauma victims occasionally cannot be intubated by emergency staff via conventional techniques. We sought to evaluate the efficacies of the application of the Glidescope and Airtraq in normal airway, tongue edema and face-to-face tracheal intubation models as used by emergency medical staff. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Following approval from the local human research ethics committee, 14 emergency medical staff enrolled in this study. The participants attempted to intubate pediatric manikins in three different airway models (in a random order) with a Glidescope, Airtraq and Direct Laryngoscope. R Re es su ul lt ts s: : All emergency medical staff intubated the normal and tongue edema models successfully with the three devices. The intubation success rates for the Airtraq and Glidescope were 93% with the face-to-face approach (entrapped). The intubation time with the Glidescope was longer than that for the other devices in three models (p=0.001, p=0.02, p=0.02). When compared within groups, the intubation time for the Glidescope was increased relative to the normal face-to-face approach (16 [14.0-21.5] seconds vs. 31 [18.8-34.3] seconds, 57 [43.0-71.0] seconds; p<0.001). This was not the case when we examined the other devices. C Co on nc cl lu us si io on n: : The emergency medical staff was able to intubate the pediatric manikin in the tongue edema and face-to-face models with the Glidescope and Airtraq with similar rates of success. In the Glidescope group, tracheal intubation required much more time, but this prolongation was clinically negligible. This study has been registered at www.clinicaltrials.gov.tr (NCT02478203).K Ke ey y W Wo or rd ds s: : Intubation; pediatrics Ö ÖZ ZE ET T A Am ma aç ç: : Travma mağdurları, acil çalışanları tarafından bazen konvansiyonel tekniklerle entübe edilememektedir. Biz pediatrik maketin acil çalışanları tarafından entübasyonunda Glideskop ve Airtraq'in etkinliğini; normal hava yolu, dil ödemi ve yüz yüze trakeal entübasyon modellerinde araştırmayı amaçladık. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : İnsan Araştırmaları Etik Komitesinden onay alındıktan sonra, bu çalışmaya 14 acil çalışanı dahil edildi. Katılımcılar, pediatrik maket üzerinde üç değişik modelde (sırayla; normal havayolu, dil ödemi ve yüzyüze) entübasyon uyguladılar. B Bu ul lg gu ul la ar r: : Acil çalışanları normal havayolu ve dil ödemi modellerini üç havayolu aracı ile de başarıyla entübe ettiler. Yüz yüze yaklaşımda Airtraq ve Glidescope'un entübasyon başarı oranları %93 bulundu. Glideskop ile entübasyon süresi üç modelde de di...