Airway management in space: a novice skill?

Tanqueray, Eleanor; Eusuf, Danielle; England, Emma L.; Pinder, Annie; Shelton, Clifford L.

doi:10.1016/j.bja.2020.08.030

Cited by 1 publication

(1 citation statement)

References 8 publications

(11 reference statements)

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“…Finally, in most configurations, tracheal intubation would likely be performed by a non-expert astronaut, with minimal or no pre-existing training facing a risk of competency fading. Skill maintenance is problematic, with the risk of fading dexterity after an extended absence of practice, even after an adequate initial training 46 .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of free-floating tracheal intubation in weightlessness via ice-pick position with a direct laryngoscopy and classic approach with indirect videolaryngoscopy

Thierry,

Jaulin,

Starck

et al. 2023

npj Microgravity

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Long duration spaceflights to the Moon or Mars are at risk for emergency medical events. Managing a hypoxemic distress and performing an advanced airway procedure such as oro-tracheal intubation may be complicated under weightlessness due to ergonomic constraints. An emergency free-floating intubation would be dangerous because of high failure rates due to stabilization issues that prohibits its implementation in a space environment. Nevertheless, we hypothesized that two configurations could lead to a high first-pass success score for intubation performed by a free-floating operator. In a non-randomized, controlled, cross-over simulation study during a parabolic flight campaign, we evaluated and compared the intubation performance of free-floating trained operators, using either a conventional direct laryngoscope in an ice-pick position or an indirect laryngoscopy with a video-laryngoscope in a classic position at the head of a high-fidelity simulation manikin, in weightlessness and in normogravity. Neither of the two tested conditions reached the minimal terrestrial ILCOR recommendations (95% first-pass success) and therefore could not be recommended for general implementation under weightlessness conditions. Free-floating video laryngoscopy at the head of the manikin had a significant better success score than conventional direct laryngoscopy in an ice-pick position. Our results, combined with the preexisting literature, emphasis the difficulties of performing oro-tracheal intubation, even for experts using modern airway devices, under postural instability in weightlessness. ClinicalTrials registration number NCT05303948.

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Section: Discussionmentioning

confidence: 99%