Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-28T14:32:38.222Z Has data issue: false hasContentIssue false
  • English
  • Français

Feasibility and speed of insertion of seven supraglottic airway devices under simulated airway conditions

Published online by Cambridge University Press:  11 May 2015

Oliver Robak ,
Marco Leonardelli ,
Konstantin Zedtwitz-Liebenstein ,
Kurt Rützler ,
Ernst Schuster ,
Sonia Vaida ,
Ramez Salem  and
Michael Frass
Oliver Robak*
Affiliation:
Department of Medicine I, Medical University Vienna, Vienna, Austria
Marco Leonardelli
Affiliation:
Department of Medicine I, Medical University Vienna, Vienna, Austria
Konstantin Zedtwitz-Liebenstein
Affiliation:
Head Office of Vienna Hospital Association, Vienna, Austria
Kurt Rützler
Affiliation:
Department of Anesthesiology and General Intensive Care, Medical University Vienna, Vienna, Austria
Ernst Schuster
Affiliation:
Center for Medical Statistics, Informatics and Intelligent Systems, Medical University Vienna, Vienna, Austria
Sonia Vaida
Affiliation:
Department of Anesthesiology, Penn State Milton S. Hershey Medical Center, Hershey, PA
Ramez Salem
Affiliation:
Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL
*
Department of Medicine I, Intensive Care Unit, Medical University Vienna, Waehringer Guertel 18-20, A 1090 Vienna, Austria; oliver.robak@meduniwien.ac.at.

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objectives:

Endotracheal intubation (ETI) is considered the gold standard for protecting the airway. Alternative devices for airway protection have been developed that can be used by untrained personnel, by those with less experience, and for when ETI is not possible. The main goals of our study were to evaluate the success rate and speed of insertion of different supraglottic airway devices and to determine whether the devices could be properly inserted under simulated critical conditions.

Methods:

Fifty medical students used an airway simulation trainer (Laerdal SimMan 3G) to assess the success rate and time used to insert seven different supraglottic airway devices under simulated physiologic and pathologic conditions in two different runs.

Results:

Although all airway devices could be inserted without problems, only the Combitube and the EasyTube could be successfully inserted in simulations of trismus, limited mobility of the cervical spine, or a combination of pathologic conditions such as trismus plus limited mobility of the spine and trismus plus tongue edema. The insertion time was significantly longer with LMA Unique, Fastrach, and I-Gel devices in both the first and second runs.

Conclusion:

The Combitube and the EasyTube were most easily inserted under simulated conditions such as trismus, limited mobility of the cervical spine, and combined pathologic conditions. Although all devices are useful for establishing an airway by nontrained medical students in standard simulations, we suggest that the Combitube and the EasyTube may offer advantages in difficult airway situations.

Keywords

emergency medicinemanikinsupraglottic airway
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 14 , Issue 6 , November 2012 , pp. 330 - 334
Copyright
Copyright © Canadian Association of Emergency Physicians 2012

References

REFERENCES

1.Deakin, CD, King, P, Thompson, F. Prehospital advanced airway management by ambulance technicians and paramedics: is clinical practice sufficient to maintain skills? Emerg Med J 2009;26:888–91, doi:10.1136/emj.2008.064642.CrossRefGoogle ScholarPubMed
2.Lecky, F, Bryden, D, Little, R, et al. Emergency intubation for acutely ill and injured patients. Cochrane Database Syst Rev 2008;(2):CD001429.CrossRefGoogle ScholarPubMed
3.Nolan, JP, Soar, J, Zideman, DA, et al. European Resuscitation Council Guidelines for Resuscitation 2010 Section 1. Executive summary. Resuscitation 2010;81:1219–76, doi:10.1016/j.resuscitation.2010.08.021.CrossRefGoogle ScholarPubMed
4.Wilson, RM, Runciman, WB, Gibberd, RW, et al. The Quality in Australian Health Care Study. Med J Aust 1995;163:458–71.CrossRefGoogle ScholarPubMed
5.Wu, AW, Folkman, S, McPhee, SJ, et al. Do house officers learn from their mistakes? JAMA 1991;265:2089–94, doi:10.1001/jama.1991.03460160067031.CrossRefGoogle ScholarPubMed
6.Perkins, GD, Barrett, H, Bullock, I, et al. The Acute Care Undergraduate TEaching (ACUTE) Initiative: consensus development of core competencies in acute care for undergraduates in the United Kingdom. Intensive Care Med 2005;31:1627–33, doi:10.1007/s00134-005-2837-4.CrossRefGoogle ScholarPubMed
7.Smith, CM, Perkins, GD, Bullock, I, et al. Undergraduate training in the care of the acutely ill patient: a literature review. Intensive Care Med 2007;33:901–7, doi:10.1007/s00134-007-0564-8.CrossRefGoogle ScholarPubMed
8.MacDowall, J. The assessment and treatment of the acutely ill patient—the role of the patient simulator as a teaching tool in the undergraduate programme. Med Teach 2006;28:326–9, doi:10.1080/01421590600625130.CrossRefGoogle ScholarPubMed
9.Jackson, KM, Cook, TM. Evaluation of four airway training manikins as patient simulators for the insertion of eight types of supraglottic airway devices. Anaesthesia 2007;62:388–93, doi:10.1111/j.1365-2044.2007.04983.x.Google Scholar
10.Nolan, JP, Deakin, CD, Soar, J, et al. European Resuscitation Council guidelines for resuscitation 2005. Section 4. Adult advanced life support. Resuscitation 2005;67 Suppl 1:S39–86, doi:10.1016/j.resuscitation.2005.10.009.CrossRefGoogle ScholarPubMed
11.Caplan, RA, Posner, KL, Ward, RJ, et al. Adverse respiratory events in anesthesia: a closed claims analysis. Anesthesiology 1990;72:828–33, doi:10.1097/00000542-199005000-00010.CrossRefGoogle ScholarPubMed
12.Wang, HE, Simeone, SJ, Weaver, MD, et al. Interruptions in cardiopulmonary resuscitation from paramedic endotracheal intubation. Ann Emerg Med 2009;54:645–52 e641, doi:10.1016/j.annemergmed.2009.05.024.CrossRefGoogle ScholarPubMed
13.Bein, B, Carstensen, S, Gleim, M, et al. A comparison of the proseal laryngeal mask airway, the laryngeal tube S and the oesophageal-tracheal Combitube during routine surgical procedures. Eur J Anaesthesiol 2005;22:341–6, doi:10.1017/S026502150500058X.CrossRefGoogle ScholarPubMed
14.Bollig, G, Lovhaug, SW, Sagen, O, et al. Airway management by paramedics using endotracheal intubation with a laryngoscope versus the oesophageal tracheal Combitube and Easy Tube on manikins: a randomised experimental trial. Resuscitation 2006;71:107–11, doi:10.1016/j.resuscitation.2006.02.016.CrossRefGoogle Scholar
15.Rabitsch, W, Schellongowski, P, Staudinger, T, et al. Comparison of a conventional tracheal airway with the Combitube in an urban emergency medical services system run by physicians. Resuscitation 2003;57:27–32, doi:10.1016/S0300-9572(02)00435-5.CrossRefGoogle Scholar
16.Levitan, RM, Ochroch, EA, Stuart, S, et al. Use of the intubating laryngeal mask airway by medical and nonmedical personnel. Am J Emerg Med 2000;18:12–6, doi:10.1016/S0735-6757(00)90040-8.CrossRefGoogle ScholarPubMed
17.Wahlen, BM, Roewer, N, Lange, M, et al. Tracheal intubation and alternative airway management devices used by healthcare professionals with different level of pre-existing skills: a manikin study. Anaesthesia 2009;64:549–54, doi:10.1111/j.1365-2044.2008.05812.x.Google Scholar
18.Huter, L, Schwarzkopf, K, Rodiger, J, et al. Students insert the laryngeal tube quicker and more often successful than the esophageal-tracheal combitube in a manikin. Resuscitation 2009;80:930–4, doi:10.1016/j.resuscitation.2009.04.038.CrossRefGoogle Scholar
19.Trabold, B, Schmidt, C, Schneider, B, et al. Application of three airway devices during emergency medical training by health care providers—a manikin study. Am J Emerg Med 2008;26:783–8, doi:10.1016/j.ajem.2007.11.006.CrossRefGoogle ScholarPubMed
20.Fischer, H, Hochbrugger, E, Fast, A, et al. Performance of supraglottic airway devices and 12 month skill retention: a randomized controlled study with manikins. Resuscitation 2011;82:326–31.CrossRefGoogle ScholarPubMed