Comparison of intubation devices in level C personal protective equipment: A cadaveric study

Taylor, R. S.; Pitzer, Matthew; Goldman, Grayson; Czysz, Augusta; Simunich, Thomas; Ashurst, John

doi:10.1016/j.ajem.2017.10.047

Cited by 20 publications

(18 citation statements)

References 12 publications

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“…In Polish settings, EMS personnel are usually equipped with a full protective suit, a mask with FFP2 or FFP3 class filter, protective glasses, visor and double gloves. This garment reduces the risk of infection but, as numerous studies have shown, makes it difficult to perform medical procedures, including those so important for cardiopulmonary resuscitation, such as chest compressions [11], airway management [12,13], obtaining vascular access [14,15], or the administration of drugs and fluids during resuscitation [16,17].…”

Section: Introductionmentioning

confidence: 99%

Out-of-hospital cardiac arrest treated by emergency medical service teams during COVID-19 pandemic: A retrospective cohort study

Borkowska¹,

Smereka

Safiejko³

et al. 2021

Cardiol J.

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Background: Out-of-hospital cardiac arrest (OHCA) is a challenge for medical personnel, especially in the current COVID-19 pandemic, where medical personnel should perform resuscitation wearing full personal protective equipment. This study aims were to assess the characteristics and outcomes of adults who suffered an out-of-hospital cardiac arrest in the COVID-19 pandemic treated by emergency medical service (EMS) teams. Methods: All EMS-attended OHCA adults over than 18 years in the Polish EMS registry were analyzed. The retrospective EMS database was conducted. EMS interventions performed between March 1, and April 30, 2020 were retrospectively screened. Results: In the study period EMS operated 527 times for OHCA cases. The average age of patients with OHCA was 67.8 years. Statistically significantly more frequently men were involved (64.3%). 298 (56.6%) of all OHCA patients had resuscitation attempted by EMS providers. Among resuscitated patients, 73.8% were cardiac etiology. 9.4% of patients had return of spontaneous circulation, 27.2% of patients were admitted to hospital with ongoing chest compression. In the case of 63.4% cardiopulmonary resuscitation was ineffective and death was determined. Conclusions: The present study found that OHCA incidence rate in the Masovian population (central region of Poland) in March-April 2020 period was 12.2/100,000 adult inhabitants. Return of spontaneous circulation in EMS was observed only in 9.4% of resuscitated patients. The presence of shockable rhythms was associated with better prognosis. The prehospital mortality, even though it was high, did not differ from those reported by other studies.

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Section: Introductionmentioning

confidence: 99%

Out-of-hospital cardiac arrest treated by emergency medical service teams during COVID-19 pandemic: A retrospective cohort study

Borkowska¹,

Smereka

Safiejko³

et al. 2021

Cardiol J.

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“…These same participants had an Advanced Life Support Course, and reported having performed direct laryngoscopy at least 30 times in their career. In view of the above, after assessing the risk of bias by the highest degree identified in the domains, the general assessment of this study ( 15 ) was considered high risk, weakening the reliability of its results. This was the only study that was contrary to the favorable trend towards supraglottic devices.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Paradoxically, despite all the selected studies, a study was retrieved, whose participants were emergency physicians with level C personal protective equipment, performing orotracheal intubation and the insertion of supraglottic devices in cadavers ( 15 ) . The results suggest orotracheal intubation as a faster technique, with statistically significant data (p = 0.02) and with a higher success rate in the first attempt (direct laryngoscopy = 58% and supraglottic device = 21%) ( 15 ) . However, it is noteworthy that this study was eliminated from this systematic review because it did not present data with the respective standard deviation or means for calculating it, which made insertion in the meta-analysis unfeasible, in compliance with the provisions of the inclusion criteria.…”

Section: Discussionmentioning

confidence: 99%

“…However, there are divergences among studies on the “reduction of time to perform the procedure” and “success in the first attempt of each applied technique” outcomes. As an example, there is a study that recommends direct laryngoscopy ( 15 ) , as well as a study recommending supraglottic devices ( 16 ) , both published in 2018. For this reason, a meta-analysis was deemed necessary, since these outcomes are crucial as they directly impact the survival of victims of respiratory failure in a calamitous scenario, and provide substantial subsidies in the decision-making of the health professional about which technology should be used as a priority.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Systematic review and meta-analysis comparing ventilatory support in chemical, biological and radiological emergencies

Borges

Carvalho

Quintana

et al. 2020

Rev. Latino-Am. Enfermagem

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Objective: to compare the mean development time of the techniques of direct laryngoscopy and insertion of supraglottic devices; and to evaluate the success rate in the first attempt of these techniques, considering health professionals wearing specific personal protective equipment (waterproof overalls; gloves; boots; eye protection; mask). Method: meta-analysis with studies from LILACS, MEDLINE, CINAHL, Cochrane, Scopus and Web of Science. The keywords were the following: personal protective equipment; airway management; intubation; laryngeal masks. Results: in the “reduction of the time of the procedures” outcome, the general analysis of the supraglottic devices in comparison with the orotracheal tube initially presented high heterogeneity of the data (I2= 97%). Subgroup analysis had an impact on reducing heterogeneity among the data. The “laryngeal mask as a guide for orotracheal intubation” subgroup showed moderate heterogeneity (I2= 74%). The “2ndgeneration supraglottic devices” subgroup showed homogeneity (I2= 0%). All the meta-analyses favored supraglottic devices. In the “success in the first attempt” outcome, moderate homogeneity was found (I2= 52%), showing a higher proportion of correct answers for supraglottic devices. Conclusion: in the context of chemical, biological or radiological disaster, the insertion of the supraglottic device proved to be faster and more likely to be successful by health professionals. PROSPERO record (CRD42019136139).

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Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff

Verbeek

Rajamaki

Ijaz

et al. 2019

Cochrane Database of Systematic Reviews

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Comparison of intubation devices in level C personal protective equipment: A cadaveric study

Cited by 20 publications

References 12 publications

Out-of-hospital cardiac arrest treated by emergency medical service teams during COVID-19 pandemic: A retrospective cohort study

Out-of-hospital cardiac arrest treated by emergency medical service teams during COVID-19 pandemic: A retrospective cohort study

Systematic review and meta-analysis comparing ventilatory support in chemical, biological and radiological emergencies

Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff

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