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Direct versus video laryngoscopic intubation by novice prehospital intubators with and without chest compressions: A pilot manikin study

Authors
 Young-Min Kim  ;  Hyung-Goo Kang  ;  Ji-Hoon Kim  ;  Hyun-Soo Chung  ;  Hyeon-Woo Yim  ;  Seung-Hee Jeong 
Citation
 PREHOSPITAL EMERGENCY CARE, Vol.15(1) : 98-103, 2011 
Journal Title
PREHOSPITAL EMERGENCY CARE
ISSN
 1090-3127 
Issue Date
2011
MeSH
Adult ; Airway Management/instrumentation ; Airway Management/methods ; Allied Health Personnel ; Analysis of Variance ; Cardiopulmonary Resuscitation/instrumentation ; Cardiopulmonary Resuscitation/methods ; Chest Wall Oscillation/instrumentation ; Chest Wall Oscillation/methods* ; Clinical Competence* ; Cross-Over Studies ; Emergency Medical Services/methods* ; Emergency Medical Technicians ; Female ; Humans ; Intubation, Intratracheal/instrumentation ; Intubation, Intratracheal/methods* ; Kaplan-Meier Estimate ; Laryngoscopy/instrumentation ; Laryngoscopy/methods* ; Male ; Manikins* ; Pilot Projects ; Statistics as Topic ; Statistics, Nonparametric ; Time Factors ; Videotape Recording/instrumentation ; Videotape Recording/methods
Keywords
chest compression ; tracheal intubation ; video laryngoscope
Abstract
OBJECTIVES: To evaluate whether chest compressions affect the time taken for intubation (TTI) using the Macintosh laryngoscope and two portable video laryngoscopes (VLs) (GlideScope Ranger and Airway Scope) when used by novice prehospital caregivers, and to compare the TTIs and rates of successful intubation among the three laryngoscopes with and without chest compressions in a manikin model.

METHODS: This was a pilot randomized crossover study. Twenty paramedic students and paramedics who had no clinical experience with tracheal intubation and had never used any of two VLs participated in the study. After a one-hour training session for the VLs, participants performed intubations on a Laerdal Resusci Anne Simulator placed on the floor. Each paramedic used all three laryngoscopes, with the order of usage being randomly assigned. The TTIs and rates of successful intubation among the three laryngoscopes, with and without ongoing chest compressions, were compared.

RESULTS: The difference between the TTIs using each laryngoscope with and without chest compressions was not significant (Macintosh: 2.99 sec, p = 0.06; GlideScope Ranger: 2.04 sec, p = 0.11; and Airway Scope: 0.91 sec, p = 0.10). The median TTI using the Airway Scope (15.46 sec) was significantly shorter than those for the Macintosh (24.14 sec) and the GlideScope Ranger (24.12 sec) during chest compressions (p = 0.028 and p = 0.004, respectively). There were no significant differences in the rates of successful intubation among the three laryngoscopes on each condition (without chest compressions, p = 0.15; with chest compressions, p = 0.27), but the cumulative success rates related to the TTI were significantly greater with the Airway Scope than with the other devices in both conditions.

CONCLUSION: In this pilot study, chest compressions did not significantly affect the TTI using the Macintosh laryngoscope and two portable VLs when used by novice prehospital caregivers in the manikin model on the floor. Considering the fairly short training time, two portable VLs may be potentially useful adjuncts for tracheal intubation during chest compressions for novice prehospital caregivers. Further studies are required to validate whether these findings are clinically relevant.
Full Text
http://informahealthcare.com/doi/abs/10.3109/10903127.2010.514087
DOI
10.3109/10903127.2010.514087
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Chung, Hyun Soo(정현수) ORCID logo https://orcid.org/0000-0001-6110-1495
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/94439
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