Comparison of the airway access skills of prehospital staff in moving and stationary ambulance simulation: A randomized crossover study

Abstract

ObjectivesWe aimed to compare the procedural success and intervention durations regarding various airway access skills in moving and stationary ambulance simulations.Material and methodsAn ambulance simulator was used to simulate the moving ambulance environment, and a standard manikin was used for airway simulation. The study included 38 paramedics and paramedic students. In stationary and moving environments, a classical endotracheal intubation with a stylet, an intubation with a gum elastic bougie (GEB), a laryngeal mask airway (LMA), and a laryngeal tube (LT) were applied randomly. The cuff inflation duration, the duration until the first ventilation, and the intubation success were assessed.ResultsThere was no difference in terms of success and intubation durations of the four methods in moving and stationary environments. In both environments, the LT and LMA were inserted most rapidly (p < 0.001). There was no difference in the intubation duration and the success among the supraglottic methods. In moving and stationary environments, the intubation with a classic stylet was faster than the intubation with a GEB. The use of a GEB did not increase the intubation success.ConclusionsIn this simulation study, the moving environment did not affect the duration or success of the endotracheal intubation. Supraglottic methods were applied more quickly in both moving and stationary environments. A GEB was used successfully by practioners with no previous experience; however, the duration of the intubation was longer.

Efficacy of tracheal tube introducers and stylets for endotracheal intubation in the prehospital setting: a systematic review and meta-analysis

“…The nine remaining studies had their reference lists screened and a further four studies were identified and included. A total of 13 studies were therefore included in our qualitative synthesis [14][15][16][17][18][19][20][21][22][23][24][25][26]. Of these studies, 10 were included in our quantitative synthesis [14,15,[19][20][21][22][23][24][25][26].…”

“…Every study had at least 7% of criteria answered "CD/NA/NR" as every study investigated an exposure that could not vary in amount or level. Eight studies had 14% of criteria answered "CD/NA/ NR" [17][18][19][22][23][24][25][26] as it could not be determined whether the participation rate of eligible persons was at least 50%.…”

Laryngeal mask versus endotracheal intubation for pre-hospital emergency airway management: a meta-analysis of randomized manikin and human studies

“…A total of 14 reports, 532 non-pre-hospital emergency studies, 40 that did not use laryngeal masks, 36 with nonrandomized data and 7 with insufficient data were excluded. Finally, 9 randomized studies [8][9][10][11][12][13][14][15][16] on manikins and 31 randomized studies on humans were included. In the manikin studies, the participants included medical students, paramedics, anesthesiologists, EMT, nurses, intensive care and emergency physicians.…”

“…Overall intubation success rate A total of 8 randomized studies [8,[10][11][12][13][14][15][16] reported overall intubation success rates. No statistical heterogeneity was observed (P=0.939, I 2 = 0.0%) so a fixed effect model was employed.…”

“…Eight randomized studies [9][10][11][12][13][14][15][16] reported differences in the insertion times. A random effects model was used for statistical heterogeneity (P = 0.000, I2 = 88.7%).…”