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

Abstract

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).

Percepção dos enfermeiros sobre a utilização da máscara laríngea no serviço intra hospitalar

“…No mesmo seguimento Borges (2020); Gordon (2018); Wang (2018), referem que a ML é utilizada como um recurso em situações de intubação traqueal difícil, procedimentos cirúrgicos e atendimento de urgência e emergência, e apresenta resultados positivos na primeira tentativa de inserção. Para a sua inserção inclui teste de vazamento do manguito, desinsuflação total do manguito, lubrificação da parede posterior da ML, inserção da ML na cavidade oral ao longo do palato duro, palato mole e parede da faringe até à resistência.…”