Effect of chest compressions on the time taken to insert airway devices in a manikin

Gatward, J. J.; Thomas, Matthew; Nolan, Jerry P.; Cook, Tim

doi:10.1093/bja/aem364

Cited by 109 publications

(85 citation statements)

References 24 publications

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“…In a recent study, albeit in a manikin, the i-gel was found to be 50% faster to insert than the cLMA or tracheal tube and 25% faster than the PLMA, both with and without concurrent chest compressions being performed [18]. The only SADs currently recommended by the European Resuscitation Council for use in CPR are the cLMA, the Combitube TM (Kendall-Sheridan, Argyll, NY, USA) and the Laryngeal Tube (LT, VBM GmBbH Sulz, Germany) [20].…”

Section: Discussionmentioning

confidence: 90%

“…A study conducted in our hospital in 40 patients found that the device can be placed reliably and quickly by non-anaesthetic medical staff and medical students [17]. A recent manikin study also showed that experience had no effect on insertion; neither experience with the device itself nor overall anaesthetic experience improved time to ventilation [18]. The i-gel, once lubricated, is often inserted with remarkably little friction between it and the tissues.…”

Section: Discussionmentioning

confidence: 98%

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Evaluation of the size 4 i‐gel™ airway in one hundred non‐paralysed patients*

Gatward¹,

et al. 2008

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SummaryWe studied the i-gel TM in 100 elective, anaesthetised patients (55 : 45 male:female, median age 53 years) assessing: ease of use, airway quality, positioning, seal and complications. First insertion attempt was successful in 86 patients, second attempt in 11 patients, and third attempt in three patients. Fifty three manipulations were required in 26 patients (median 1) to achieve a clear airway. Median insertion time was 15 s. During ventilation, expired tidal volume of 7 ml.kg )1 was achieved in 96 (96%) patients. Median airway leak pressure was 24 cmH 2 O. On fibreoptic examination via the device, vocal cords were visible in 87 patients (91%). During maintenance, six patients (6%) required 12 airway manipulations. There was one episode of regurgitation, without aspiration. Other complications and patient side-effects were mild and few. The i-gel is easily and rapidly inserted, providing a reliable airway in over 90% of cases. Further studies are indicated to assess safety and performance compared to other supraglottic airway devices.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 98%

Evaluation of the size 4 i‐gel™ airway in one hundred non‐paralysed patients*

Gatward¹,

et al. 2008

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“…Gatward et al 17 reported that continuing chest compressions has a minor effect on the time for tracheal intubation. Two other studies 14,15 reported no significant difference between the Macintosh laryngoscope and the videolaryngoscopes in the time taken for intubation.…”

Section: Discussionmentioning

confidence: 99%

“…Les donne´es suivantes ont e´te´mesure´es et enregistre´es : temps jusqu'a`intubation trache´ale re´ussie (crite`re d'e´valuation principal), taux de re´ussite global, temps jusqu'a`visualisation des cordes vocales, pourcentage d'ouverture glottique, compression dentaire et facilited 'intubation. Résultats Dans les cas de voies ae´riennes normales, les temps (moyenne [e´cart interquartile]) jusqu'a`intubation trache´ale e´taient plus courts avec le Pentax-AWS (12,1 [10,1-14,4] sec) et le GlideScope (14,3 [12,[4][5][6][7][8][9][10][11][12][13][14][15][16][17]6] sec) qu'avec le laryngoscope Macintosh (16,5 [13,,1] sec) (P \ 0,03 pour les deux). La diffe´rence de temps entre les deux vide´olaryngoscopes n'e´tait pas significative d'un point de vue statistique.…”

Section: Résuméunclassified

Tracheal intubation during chest compressions using Pentax-AWS®, GlideScope®, and Macintosh laryngoscope: a randomized crossover trial using a mannequin

Shin

Choi

Han

2011

Can J Anesth/J Can Anesth

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Tracheal intubation during chest compressions using Pentax-AWS Ò , GlideScope Ò , and Macintosh laryngoscope: a randomized crossover trial using a mannequin Intubation trachéale avec le Pentax-AWS Ò , le GlideScope Ò et le laryngoscope Macintosh pendant des compressions thoraciques: une étude croisée randomisée sur un mannequin Abstract Background A randomized crossover trial was conducted to compare the performance of two videolaryngoscopes (Pentax-AWS Ò , GlideScope Ò ) with the Macintosh laryngoscope for tracheal intubation during continuous chest compressions on a mannequin. Methods Thirty-two inexperienced junior interns performed tracheal intubations on an advanced life support simulator with either a normal or difficult airway scenario. The sequence of intubating devices and airway difficulty were randomized. The following data were measured and recorded: time to complete tracheal intubation (primary end point), overall success rate, time to visualize the vocal cords, percentage of glottic opening, dental compression, and ease of intubation. Results With a normal airway, the times (median [interquartile range]) to complete tracheal intubation were shorter with the Pentax-AWS (12.1 [10.1-14.4] sec) and the ] sec) than with the Macintosh laryngoscope (16.5 [13.1-22.1] sec) (P \ 0.03 for both). The time difference between the two videolaryngoscopes was not statistically significant. With a difficult airway scenario, the times to complete tracheal intubation were 13.9 [10.9-20.4] sec, 19.2 [16.4-32.3] sec, and 30.1 [21.0-56.5] sec, respectively (P \ 0.05 for all differences). The videolaryngoscopes were also more effective than the Macintosh laryngoscope with respect to secondary outcomes. ConclusionsThe two videolaryngoscopes were superior to the Macintosh laryngoscope in terms of performing tracheal intubation during continuous chest compressions on a mannequin. In a difficult airway scenario simulating cardiac arrest, the Pentax-AWS performed better than the GlideScope. RésuméContexte Une e´tude croise´e randomise´e a e´te´re´alise´e afin de comparer la performance de deux vide´olaryngoscopes (Pentax-AWS Ò , GlideScope Ò ) et du laryngoscope Macintosh pour l'intubation trache´ale pendant des compressions thoraciques continues sur un mannequin. Méthode Trente-deux re´sidents sans expe´rience ont re´alise´des intubations trache´ales sur un simulateur de re´animation avance´e dans des sce´narios de voies ae´riennes normales ou difficiles. Les dispositifs d'intubation et la difficulte´des voies ae´riennes ont suivi un ordre d'apparition ale´atoire. Les donne´es suivantes ont e´te´mesure´es et enregistre´es : temps jusqu'a`intubation trache´ale re´ussie (crite`re d'e´valuation principal), taux de re´ussite global, temps jusqu'a`visualisation des cordes vocales, pourcentage d'ouverture glottique, compression dentaire et facilited 'intubation. Résultats Dans les cas de voies ae´riennes normales, les temps (moyenne [e´cart interquartile]) jusqu'a`intubation trache´ale e´taient plus courts avec le Pentax-AWS (12,1...

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“…Ventilation with an automated ventilator is possible, which frees the rescuer for other tasks [90]. Compared with tracheal intubation, SADs have a higher success rate and are quicker to insert [22,91] and unlike tracheal intubation, they can generally be inserted without interrupting chest compressions (at least in manikins) [92]. The unique problems of pre-hospital care (e.g.…”

Section: Intubation Through a Sadmentioning

confidence: 99%

Supraglottic airways in difficult airway management: successes, failures, use and misuse

Timmermann

2011

Anaesthesia

162

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SummarySupraglottic airway devices (SAD) play an important role in the management of patients with difficult airways. Unlike other alternatives to standard tracheal intubation, e.g. videolaryngoscopy or intubation stylets, they enable ventilation even in patients with difficult facemask ventilation and simultaneous use as a conduit for tracheal intubation. Insertion is usually atraumatic, their use is familiar from elective anaesthesia, and compared with tracheal intubation is easier to learn for users with limited experienced in airway management. Use of SADs during difficult airway management is widely recommended in many guidelines for the operating room and in the pre‐hospital setting. Despite numerous studies comparing different SADs in manikins, there are few randomised controlled trials comparing different SADs in patients with difficult airways. Therefore, most safety data come from extended use rather than high quality evidence and claims of efficacy and particularly safety must be interpreted cautiously.

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Effect of chest compressions on the time taken to insert airway devices in a manikin

Cited by 109 publications

References 24 publications

Evaluation of the size 4 i‐gel™ airway in one hundred non‐paralysed patients*

Evaluation of the size 4 i‐gel™ airway in one hundred non‐paralysed patients*

Tracheal intubation during chest compressions using Pentax-AWS®, GlideScope®, and Macintosh laryngoscope: a randomized crossover trial using a mannequin

Supraglottic airways in difficult airway management: successes, failures, use and misuse

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