Successful one-lung ventilation using the VivaSight-EB bronchial blocker tube for an emergency lung injury. A simulation pilot data

Abstract

INTRODUCTION:The ability to perform endotracheal intubation is one of the basic skills that paramedics should demonstrate. However, in some cases where lung or bronchial injuries have occurred, it may be necessary to separate the lung by attaching a bronchial blocker and ventilating single lung.The aim of the study was to evaluate the effectiveness of bronchial protection with VivaSight-EB bronchial blocker tube and one-lung ventilation by paramedics in conditions of simulated lung injury. MATERIAL AND METHODS:The study was a prospective randomized cross-over simulation trial in which 27 paramedics took part. In the study, paramedics performed endotracheal intubation with ETView SL and then introduced a VivaSight-EB bronchial blocker and one-lung ventilation. The bronchial protection procedure took place in two scenarios: (A) normal airway; (B) difficult airway. VivaSight-EB bronchial blocker introduction time (T1) and one-lung ventilation time (T2) and the efficacy of the procedure were analysed. RESULTS:The efficacy of endotracheal intubation with ETView SL tube was 100% during both Scenario A and Scenario B. The efficacy of endotracheal intubation with ETView SL tube was 100%. The effectiveness of the first attempt to protect the bronchi with a bronchial blocker was 26% for both scenarios and the total effectiveness of bronchial protection was 100% in both cases. Time T1 for endotracheal intubation was 18sec for Scenario A (IQR; and 20 sec for Scenario B (IQR;[17][18][19][20][21][22][23][24][25]. The time to perform one-lung ventilation (Time T2) in scenarios A and B was 43 sec (IQR; 38-62.5) vs. 43.5 sec (38-65). CONCLUSIONS:The simulation study confirmed the research hypothesis that the paramedics were able to perform one-lung ventilation using the ETView-Blocker® bronchial blocker tube after a short training.

Comparison of intravascular access methods applied by nurses wearing personal protective equipment in simulated COVID-19 resuscitation: A randomized crossover simulation trial

“…Firstly, it was conducted under the conditions of medical simulation and not those of real medical actions. This was, however, intentional and dictated by the fact that medical simulation allows to fully standardize the performed medical procedures, without any risk for a potential patient or the personnel involved in particular procedures [ 32 , 33 ]. This is even more important in the era of a pandemic, when the risk of potential infection is extremely real owing to the high virulence of SARS-CoV-2 [ 2 , 34 ].…”

Direct vs. Video-Laryngoscopy for Intubation by Paramedics of Simulated COVID-19 Patients under Cardiopulmonary Resuscitation: A Randomized Crossover Trial

“…Another limitation is that paramedics taking part in our study had very limited exposure to endotracheal intubation in the prehospital settings. EMS systems differ in a number of characteristics, including but not limited to the range of skills, experience, and qualifications of paramedics, including endotracheal intubation [37,38]. In our study, we analyzed paramedics with relatively limited experience in endotracheal intubation by direct laryngoscopy.…”

VivaSight single-lumen tube as an intubation method. A systematic review and meta-analysis of randomised simulation trials

“…If the camera lens is blurred by fluid from the mouth, it is possible to rinse the lens with a dedicated flushing system. Additionally, if the VivaSight SL deep endotracheal tube is inserted, it is possible to visualise the carina and introduce the bronchial blocker and one-lung ventilation without the need to confirm the position of the blocker with a fibroscope [6][7][8].…”