Comparison of Sitting Face-to-Face Intubation (Two-Person Technique) with Standard Oral-tracheal Intubation in Novices: A Mannequin Study

Venezia, Donna; Wackett, Andrew; Remedios, Alexander; Tarsia, V.

doi:10.1016/j.jemermed.2012.03.019

Cited by 15 publications

(24 citation statements)

References 25 publications

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“…12 Some authors have reported that face-to-face intubation generally requires 2 people, but single participants were able to execute this procedure in our study. 13 As in our study, previous reports in the published literature have described the single-person intubations with the face-to-face approach, and indicated that the right hand should be used to insert the blade, and the left hand should be used to tube. 11,14,15 We observed that little force was required to insert video laryngoscopes.…”

Section: Discussionsupporting

confidence: 63%

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

Arslan¹,

Aksu²,

Kibar³

et al. 2016

Turkiye Klinikleri J Anest Reanim

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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...

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Section: Discussionsupporting

confidence: 63%

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

Arslan¹,

Aksu²,

Kibar³

et al. 2016

Turkiye Klinikleri J Anest Reanim

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“…Nevertheless, traditional supine intubation remains widespread and upright intubation remains underrepresented in research and in medical education. Venezia and colleagues reported a study of novice intubators using a face-to-face technique with simulated patients in an upright position [12]. To our knowledge, there are no other studies examining the success of teaching students to intubate in an upright position.…”

Section: Discussionmentioning

confidence: 99%

Cross-over study of novice intubators performing endotracheal intubation in an upright versus supine position

et al. 2016

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. (2016). Cross-over study of novice intubators performing endotracheal intubation in an upright versus supine position. Internal and Emergency Medicine, 1-6. https://doi.org/10.1007/s11739-016-1481-z Novice Upright Intubation 2 Abstract: There are a number of potential physical advantages to performing orotracheal intubation in an upright position. The objective of this study was to measure the success of intubation of a simulated patient in an upright versus supine position by novice intubators after brief training. This was a cross-over design study in which learners (medical students, physician assistant students, and paramedic students) intubated mannequins in both a supine (head of the bed at 0 degrees) and upright (head of bed elevated at 45 degrees) position. The primary outcome of interest was successful intubation of the trachea. Secondary outcomes included log time to intubation, Cormack-Lehane view obtained, Percent of Glottic Opening score, provider assessment of difficulty, and overall provider satisfaction with the position. There were a total of 126 participants: 34 medical students, 84 physician assistant students, and 8 paramedic students. Successful tracheal intubation was achieved in 114 supine attempts (90.5%) and 123 upright attempts (97.6%; p = 0.283). Upright positioning was associated with significantly faster log time to intubation, higher likelihood of achieving Grade I Cormack-Lehane view, higher Percent of Glottic Opening score, lower perceived difficulty, and higher provider satisfaction. A subset of 74 participants had no previous intubation training or experience. For these providers, there was a non-significant trend toward improved intubation success with upright positioning vs supine positioning (98.6% vs. 87.8%, p = 0.283). For all secondary outcomes in this group, upright positioning significantly outperformed supine positioning.

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“…With the fingers in this position, manipulation of the degree of chin lift can be adjusted according to the quality of the bronchoscopic view. The bronchoscope is held by the thumb and index finger of the same handNasal intubation in the sitting positionSitting endotracheal intubation has been proven to be more successful when compared to conventional intubation[44]Using a dual bougie for nasotracheal intubation[45] When it is anticipated that the nasotracheal intubation would be difficult, but at the same time conventional orotracheal intubation could be done through conventional laryngoscopy, this technique is used. A cuffed tracheal tube is placed into the trachea.…”

Section: Nasal Intubation Techniquesmentioning

confidence: 99%

Nasal intubation: A comprehensive review

Chauhan

Acharya

2016

Indian Journal of Critical Care Medicine

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Nasal intubation technique was first described in 1902 by Kuhn. The others pioneering the nasal intubation techniques were Macewen, Rosenberg, Meltzer and Auer, and Elsberg. It is the most common method used for giving anesthesia in oral surgeries as it provides a good field for surgeons to operate. The anatomy behind nasal intubation is necessary to know as it gives an idea about the pathway of the endotracheal tube and complications encountered during nasotracheal intubation. Various techniques can be used to intubate the patient by nasal route and all of them have their own associated complications which are discussed in this article. Various complications may arise while doing nasotracheal intubation but a thorough knowledge of the anatomy and physics behind the procedure can help reduce such complications and manage appropriately. It is important for an anesthesiologist to be well versed with the basics of nasotracheal intubation and advances in the techniques. A thorough knowledge of the anatomy and the advent of newer devices have abolished the negative effect of blindness of the procedure.

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Comparison of Sitting Face-to-Face Intubation (Two-Person Technique) with Standard Oral-tracheal Intubation in Novices: A Mannequin Study

Cited by 15 publications

References 25 publications

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

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

Cross-over study of novice intubators performing endotracheal intubation in an upright versus supine position

Nasal intubation: A comprehensive review

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