Tracheal intubation while wearing personal protective equipment in simulation studies: a systematic review and meta-analysis with trial-sequential analysis

Sanfilippo, Filippo; Tigano, Stefano; Rosa, Valeria La; Morgana, Alberto; Murabito, Paolo; Oliveri, Francesco; Longhini, Federico; Astuto, Marinella

doi:10.1016/j.bjane.2021.08.017

Cited by 10 publications

(10 citation statements)

References 31 publications

(65 reference statements)

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“…The benefits seen in increasing success rates for tracheal intubation with videolaryngoscopy are particularly noticeable when clinicians are wearing personal protective equipment (PPE) [30].…”

Section: Strategies For Improving Human Factors In Anaesthesiamentioning

confidence: 99%

“…Videolaryngoscopy also reduces mechanical stress on the neck, back and shoulders of the clinician, decreasing the likelihood of worker injury [28] and can prevent the transmission of infections during tracheal intubation by increasing the distance between the patient's and operator's airways [29]. The benefits seen in increasing success rates for tracheal intubation with videolaryngoscopy are particularly noticeable when clinicians are wearing personal protective equipment (PPE) [30].…”

Section: Strategies For Improving Human Factors In Anaesthesiamentioning

confidence: 99%

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Human factors in anaesthesia: a narrative review

et al. 2023

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Healthcare relies on high levels of human performance, as described by the `human as the hero´concept. However, human performance varies and is recognised to fall in high-pressure situations, meaning that it is not a reliable method of ensuring safety. Other safety-critical industries embed human factors principles into all aspects of their organisations to improve safety and reduce reliance on exceptional human performance; there is potential to do the same in anaesthesia. Human factors is a broad-based scientific discipline which aims to make it as easy as possible for workers to do things correctly. The human factors strategies most likely to be effective are those which `design out´the chance of an error or adverse event occurring. When errors or adverse events do happen, barriers are in place to trap them and reduce the risk of progression to patient and/or worker harm. If errors or adverse events are not trapped by these barriers, mitigations are in place to minimise the consequences. Non-technical skills form an important part of human factors barriers and mitigation strategies and include: situation awareness; decision-making; task management; and team working. Human factors principles are not a substitute for proper investment and appropriate staffing levels. Although applying human factors science has the potential to save money in the long term, its proper implementation may require investment before reward can be reaped. This narrative review describes what is known about human factors in anaesthesia to date.

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Section: Strategies For Improving Human Factors In Anaesthesiamentioning

confidence: 99%

Section: Strategies For Improving Human Factors In Anaesthesiamentioning

confidence: 99%

Human factors in anaesthesia: a narrative review

et al. 2023

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“…This recommendation is theoretically plausible. However, it remains unclear whether VLs are a better option than DLs while wearing cumbersome PPE, which can impede the performance of the intubator [ 8 ]. Several studies have compared DLs and VLs in a simulation context in which the intubators wore PPE; however, the findings of those studies have conflicted with one another, and clinical evidence is lacking [ 9 , 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Endotracheal Intubation Using C-MAC Video Laryngoscope vs. Direct Laryngoscope While Wearing Personal Protective Equipment

Kim

Jeong

Park

et al. 2022

JPM

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This study sought to determine whether the C-MAC video laryngoscope (VL) performed better than a direct laryngoscope (DL) when attempting endotracheal intubation (ETI) in the emergency department (ED) while wearing personal protective equipment (PPE). This was a retrospective single-center observational study conducted in an academic ED between February 2020 and March 2022. All emergency medical personnel who participated in any ETI procedure were required to wear PPE. The patients were divided into the C-MAC VL group and the DL group based on the device used during the first ETI attempt. The primary outcome measure was the first-pass success (FPS) rate. A multiple logistic regression was used to determine the factors associated with FPS. Of the 756 eligible patients, 650 were assigned to the C-MAC group and 106 to the DL group. The overall FPS rate was 83.5% (n = 631/756). The C-MAC group had a significantly higher FPS rate than the DL group (85.7% vs. 69.8%, p < 0.001). In the multivariable logistic regression analysis, C-MAC use was significantly associated with an increased FPS rate (adjusted odds ratio, 2.86; 95% confidence interval, 1.69–4.08; p < 0.001). In this study, we found that the FPS rate of ETI was significantly higher when the C-MAC VL was used than when a DL was used by emergency physicians constrained by cumbersome PPE.

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“…For all the reasons above, in this issue of the Brazilian Journal of Anesthesiology , we invite readers to access several interesting studies providing new insights into the role of the anesthesiologist in the COVID-19 pandemic. 14 , 15 , 16 , 17 , 18 , 19 , 20 These studies have addressed a myriad of COVID-19-related topics, including the risk for environmental exposure to the SARS-CoV-2, potential protective measures to reduce contamination during airway management, mental health of healthcare providers and education concerns during the pandemic, a new technique for percutaneous tracheostomy in COVID-19 patients, and potential benefits of early awake prone positioning in patients displaying COVID-19-related ARDS.…”

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confidence: 99%