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Han S, Choi P, Hong C, Shin D, Na J, Hwang S, Cho J. Can use of video Laryngoscopes by Emergency Medical Technicians Facilitate Endotracheal Intubation during Continuous Chest Compression? A Manikin Study. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791402100505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction We conducted this study to evaluate the utility of two video laryngoscopes (VLs) [Pentax-AWS (AWS), GlideScope (GVL)], compared to the conventional Macintosh laryngoscope (ML), on endotracheal intubation (ETI) involving chest compressions by Level 1 Korean emergency medical technicians (EMTs) who are the equivalent of EMT-I in the United States. Methods This was a randomised crossover simulation study. Fifty EMTs performed endotracheal intubation in randomised sequence following two different scenarios: normal airway and difficult airway. Results In normal airway scenario, overall success rate did not differ between the three devices. However AWS required a shorter run-time (14.1 [10.9-19.8] seconds) to complete ETI (TC) than ML (17.7 [13.5-21.3] seconds) (p=0.017). And both VLs showed a significant superiority over ML in time required to visualise vocal cords (TVC), percentage of glottic opening (POGO) score, and incidence of dental compression (IDC). In difficult airway scenario, overall success rate of both VLs was significantly higher than ML. The TC of AWS (13.7 [11.2-16.9] seconds) and GVL (20.7 [15.1-25.9] seconds) was shorter than that of ML (24.7 [18.1-34.5] seconds) (p<0.001). The TVC of GVL was significantly shorter than that of AWS and ML. The POGO score, IDC, and ease of intubation were significantly superior with AWS, GVL, and ML, respectively. Conclusions Video laryngoscopes can facilitate EMT performing a faster and easier intubation without interrupting chest compressions. Moreover, AWS improves the success rate comparing to ML in difficult airway management. (Hong Kong j.emerg.med. 2014;21:308-315)
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Affiliation(s)
- Sk Han
- Kangwon National University Hospital, Department of Emeregncy Medicine, Institute of Medical Sciences, School of Medicine, Kangwon National University, 1 Gangwondaehak-gil, Chuncheon-si, Gangwon-do, South Korea
| | | | - Ck Hong
- Bundang Jesaeng General Hospital, Department of Emeregncy Medicine, 255-2 Seohyun-dong, Bundang-gu, Seongnam, South Korea
| | - Dh Shin
- Kangwon National University Hospital, Department of Emeregncy Medicine, Institute of Medical Sciences, School of Medicine, Kangwon National University, 1 Gangwondaehak-gil, Chuncheon-si, Gangwon-do, South Korea
| | | | - Sy Hwang
- Samsung Changwon Hospital, Department of Emeregncy Medicine, Sungkyunkwan University School of Medicine, 158 Palyoung-ro, MasanHoiwon-gu, Changwon, South Korea
| | - Jh Cho
- Kangwon National University Hospital, Department of Emeregncy Medicine, Institute of Medical Sciences, School of Medicine, Kangwon National University, 1 Gangwondaehak-gil, Chuncheon-si, Gangwon-do, South Korea
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Fujisawa T, Komasawa N, Hattori K, Mihara R, Minami T. Manual laryngeal fixation facilitates tracheal intubation during chest compression: A randomized crossover manikin study. Am J Emerg Med 2017; 35:671-675. [DOI: 10.1016/j.ajem.2016.12.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 12/24/2016] [Indexed: 10/20/2022] Open
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Komasawa N, Nishihara I, Minami T. Effects of stylet use during tracheal intubation on postoperative pharyngeal pain in anesthetized patients: A prospective randomized controlled trial. J Clin Anesth 2017; 38:68-70. [PMID: 28372682 DOI: 10.1016/j.jclinane.2017.01.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 01/16/2017] [Accepted: 01/21/2017] [Indexed: 10/20/2022]
Abstract
STUDY OBJECTIVE This study aimed to compare the impact of stylet application for tracheal intubation for postoperative pharyngeal pain or hoarseness in patients undergoing elective surgery. DESIGN Randomized clinical trial. SETTING Operating room. PATIENTS Forty adult patients scheduled for elective surgery under tracheal intubation with an ASA physical status of 1-3. INTERVENTIONS Tracheal intubation was performed by anesthesiologists with stylet group (Stylet group; 20 patients) or without stylet group (Control group; 20 patients). MEASUREMENTS Incidence of postoperative pharyngeal pain or hoarseness was assessed. MAIN RESULTS The incidence of postoperative pharyngeal pain was significantly higher in the Stylet group (10/20 patients) than in the Control group (2/20 patients) (P=0.013). The incidence of hoarseness did not significantly differ between the Stylet group (6/20 patients) and the Control group (3/20 patients) (P=0.45). CONCLUSIONS Stylet use increases the incidence of postoperative pharyngeal pain.
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Affiliation(s)
| | - Isao Nishihara
- Department of Anaesthesiology, Hokusetsu General Hospital, Japan
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Ohchi F, Komasawa N, Mihara R, Hattori K, Minami T. Evaluation of gum-elastic bougie combined with direct and indirect laryngoscopes in vomitus setting: A randomized simulation trial. Am J Emerg Med 2016; 35:584-588. [PMID: 28034484 DOI: 10.1016/j.ajem.2016.12.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 12/09/2016] [Accepted: 12/12/2016] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Videolaryngoscopes may not be useful in the presence of vomitus due to blurred images on the monitor. The objective of our study is to compare the utility of gum-elastic bougie (GEB) application for tracheal intubation with the Macintosh laryngoscope (McL), which is a direct laryngoscope, with that of the Pentax-AWS Airwayscope® (AWS) and McGRATH® MAC (McGRATH) in simulated vomitus settings. METHODS Sixteen novice doctors performed tracheal intubation on an adult manikin using McL, AWS, and McGRATH with or without GEB under normal and vomitus simulations. RESULTS In the normal setting the tracheal intubation was successful with the three laryngoscopes regardless of GEB application. In the vomitus setting, the intubation success rate did not significantly improve using McL, while it did using McGRATH or AWS. In the normal settings, GEB application significantly lengthened the intubation time in all three laryngoscopes. By contrast, in the vomitus settings, GEB application significantly shortened the intubation time in all three laryngoscopes. For the comparison of three laryngoscopes, the intubation time did not differ significantly in normal setting, while it was significantly longer in McG and AWS trials than McL trial. CONCLUSION The GEB application facilitates the tracheal intubation in the vomitus setting using McGRATH and AWS in adult simulation.
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Affiliation(s)
- Fumihiro Ohchi
- Department of Anesthesiology, Osaka Medical College, Japan
| | | | - Ryosuke Mihara
- Department of Anesthesiology, Osaka Medical College, Japan
| | - Kazuo Hattori
- Department of Anesthesiology, Osaka Medical College, Japan
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Comparison of cricoid pressure effect between McGRATH® MAC and Pentax-AWS Airwayscope®: A prospective randomized trials. Am J Emerg Med 2016; 35:576-578. [PMID: 27986337 DOI: 10.1016/j.ajem.2016.12.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 12/09/2016] [Accepted: 12/09/2016] [Indexed: 11/23/2022] Open
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Impact of pillow height on double-lumen endotracheal tube intubation with McGRATH MAC: a prospective randomized clinical trial. J Clin Anesth 2016; 34:339-43. [DOI: 10.1016/j.jclinane.2016.05.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 05/04/2016] [Accepted: 05/04/2016] [Indexed: 11/23/2022]
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7
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Komasawa N, Minami T. A novel bimanual lip extraction and backward, upward, rightward pressure combination for improved laryngoscopy. Am J Emerg Med 2016; 35:177. [PMID: 27771226 DOI: 10.1016/j.ajem.2016.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 10/06/2016] [Indexed: 10/20/2022] Open
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Komasawa N, Mihara R, Kido H, Minami T. Possibility of lip pulling method not only for prevention of soft tissue injury but also for improved laryngoscopy and tracheal intubation. Am J Emerg Med 2016; 34:1694. [PMID: 27210729 DOI: 10.1016/j.ajem.2016.05.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 05/10/2016] [Indexed: 10/21/2022] Open
Affiliation(s)
| | | | - Haruki Kido
- Department of Anesthesiology, Osaka Medical College
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Ueno T, Komasawa N, Majima N, Mihara R, Minami T. Tracheal Tube Position Shift During Infant Resuscitation by Chest Compression: A Simulation Comparison by Fixation Method and With or Without Cuff. J Emerg Med 2016; 50:601-6. [PMID: 26823135 DOI: 10.1016/j.jemermed.2015.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 11/03/2015] [Accepted: 11/20/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND Tracheal tube placement during infant resuscitation is essential for definite airway protection. Accidental extubation due to tracheal tube displacement is a rare event, but it results in severe complications, especially in infants. OBJECTIVE The present study evaluated how infant tracheal tube displacement is affected by tape vs. tube holder fixation using a manikin. METHODS A tracheal tube with internal diameter of 3.5 mm was placed 10 cm from the gum ridge in an advanced life support (ALS) Baby(®) simulator (Laerdal, Stavanger, Norway). In the first trial, cuff pressure was set at 15, 20, and 25 cmH2O and trials were performed at each setting with no fixation, Durapore(®) (3M, St Paul, MN) tape fixation, Multipore(®) (3M) tape fixation, and Thomas(®) Tube Holder (Laerdal) fixation. After 5 min of chest compression, the tracheal tube shift was measured. In the second trial, we compared the tube shift by chest compression with or without cuff in the same way. RESULTS Relative to no fixation, tracheal tube shift was significantly less in the Durapore, Multipore, and tube holder groups (p < 0.05) at all cuff settings. Of the three fixation methods, the tube holder showed significantly less shift (p < 0.05) relative to tape, regardless of the initial cuff pressure. The positional shift after chest compressions was significantly larger in the trials with cuff than in those without cuff in Durapore or Multipore fixation (p < 0.05), but did not in tube holder fixation. CONCLUSIONS There is less tracheal tube displacement with tube holder fixation than with tape during continuous infant chest compression simulation. The tube cuff can contribute to the positional shift of the tube during infant chest compression.
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Affiliation(s)
- Takeshi Ueno
- Department of Anesthesiology, Osaka Medical College, Osaka, Japan
| | | | - Nozomi Majima
- Department of Anesthesiology, Osaka Medical College, Osaka, Japan
| | - Ryosuke Mihara
- Department of Anesthesiology, Osaka Medical College, Osaka, Japan
| | - Toshiaki Minami
- Department of Anesthesiology, Osaka Medical College, Osaka, Japan
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Komasawa N, Cho T, Mihara R, Minami T. Utility of gum-elastic bougie for tracheal intubation during chest compressions in a manikin: a randomized crossover trial. Am J Emerg Med 2015; 34:54-6. [PMID: 26456492 DOI: 10.1016/j.ajem.2015.09.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 09/12/2015] [Accepted: 09/14/2015] [Indexed: 10/23/2022] Open
Abstract
PURPOSE The utility of the gum-elastic bougie (GEB) as an assistive device for tracheal intubation during chest compressions has not been sufficiently validated. This study aimed to compare the utility of the GEB during chest compressions on an adult manikin. METHODS Seventeen novice physicians performed tracheal intubation on an adult manikin using the GEB with or without chest compressions. Intubation success rate, intubation time, subjective difficulty of laryngoscopy, and tube passage through the glottis were measured. P < .05 was considered as significantly different. RESULTS All novice physicians successfully secured the airway without chest compression with and without the GEB. In contrast, during chest compressions, 7 failed without the GEB, whereas only 1 failed with the GEB (P = .007). Intubation time was significantly longer with chest compressions regardless of GEB use (P < .001). Both laryngoscopy and tube passage through the glottis were perceived as significantly more difficult with chest compressions, regardless of GEB use (P < .001). Subjective difficulty of tube passage through the glottis during chest compression was perceived as significantly more easy by GEB application (P < .001). CONCLUSIONS These findings suggest that the GEB facilitates tracheal intubation during chest compressions performed by novice physicians in adult simulations.
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Affiliation(s)
| | - Takashi Cho
- Department of Anesthesiology, Osaka Medical College, Japan
| | - Ryosuke Mihara
- Department of Anesthesiology, Osaka Medical College, Japan
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Evaluation of the efficacy of six supraglottic devices for airway management in dark conditions: a crossover randomized simulation trial. J Anesth 2015. [DOI: 10.1007/s00540-015-2050-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Comparisons of the Pentax-AWS, Glidescope, and Macintosh Laryngoscopes for Intubation Performance during Mechanical Chest Compressions in Left Lateral Tilt: A Randomized Simulation Study of Maternal Cardiopulmonary Resuscitation. BIOMED RESEARCH INTERNATIONAL 2015; 2015:975649. [PMID: 26161426 PMCID: PMC4487700 DOI: 10.1155/2015/975649] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 12/25/2014] [Indexed: 12/02/2022]
Abstract
Purpose. Rapid advanced airway management is important in maternal cardiopulmonary resuscitation (CPR). This study aimed to compare intubation performances among Pentax-AWS (AWS), Glidescope (GVL), and Macintosh laryngoscope (MCL) during mechanical chest compression in 15° and 30° left lateral tilt. Methods. In 19 emergency physicians, a prospective randomized crossover study was conducted to examine the three laryngoscopes. Primary outcomes were the intubation time and the success rate for intubation. Results. The median intubation time using AWS was shorter than that of GVL and MCL in both tilt degrees. The time to visualize the glottic view in GVL and AWS was significantly lower than that of MCL (all P < 0.05), whereas there was no significant difference between the two video laryngoscopes (in 15° tilt, P = 1; in 30° tilt, P = 0.71). The progression of tracheal tube using AWS was faster than that of MCL and GVL in both degrees (all P < 0.001). Intubations using AWS and GVL showed higher success rate than that of Macintosh laryngoscopes. Conclusions. The AWS could be an appropriate laryngoscope for airway management of pregnant women in tilt CPR considering intubation time and success rate.
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Kido H, Komasawa N, Matsunami S, Kusaka Y, Minami T. Comparison of McGRATH MAC and Macintosh laryngoscopes for double-lumen endotracheal tube intubation by anesthesia residents: a prospective randomized clinical trial. J Clin Anesth 2015; 27:476-80. [PMID: 26111665 DOI: 10.1016/j.jclinane.2015.05.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Revised: 04/21/2015] [Accepted: 05/21/2015] [Indexed: 11/15/2022]
Abstract
STUDY OBJECTIVE This study aimed to compare the utility of McGRATH MAC (McG) and Macintosh (McL) laryngoscopes for double-lumen endotracheal tube intubation in patients undergoing elective surgery. DESIGN Randomized clinical trial. SETTING Operating room. PATIENTS Fifty adult patients scheduled for elective surgery under 1-lung ventilation with American Society of Anesthesiologists physical status 1 to 3. INTERVENTIONS Double-lumen endotracheal tube intubation was performed with the McG (McG group; 25 patients) or conventional McL (McL group; 25 patients) laryngoscope by anesthesia residents. MEASUREMENTS The number of attempts to successful intubation, intubation time, percentage of glottis opening score, and subjective difficulty of laryngoscopy and tube passage through the glottis were assessed. MAIN RESULTS The total numbers of intubation attempts were 1 (McG group, 24 patients; McL group, 16 patients), 2 (McG group, 1 patient; McL group, 8 patients), and 3 (McG group, 0 patient; McL group, 1 patient), with significant differences between the two groups (P = .018). Intubation time was significantly shorter in the McG group compared with the McL group (McG: 17.1 ± 4.6 seconds vs McL: 20.8 ± 5.9 seconds, P = .026). The percentage of glottis opening score was significantly higher in the McG group compared with the McL group (McG: 88.4% ± 13.7% vs McL: 71.4% ± 20.4%, P = .004). CONCLUSIONS The McG demonstrated a better intubation profile compared with the McL, possibly due to its ease of use for double-lumen endotracheal tube intubation. Clinical Trial registry number: UMIN000014636.
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Affiliation(s)
- Haruki Kido
- Department of Anesthesiology, Osaka Medical College, Daigaku-machi 2-7, Takatsuki, Osaka 569-8686 Japan
| | - Nobuyasu Komasawa
- Department of Anesthesiology, Osaka Medical College, Daigaku-machi 2-7, Takatsuki, Osaka 569-8686 Japan.
| | - Sayuri Matsunami
- Department of Anesthesiology, Osaka Medical College, Daigaku-machi 2-7, Takatsuki, Osaka 569-8686 Japan
| | - Yusuke Kusaka
- Department of Anesthesiology, Osaka Medical College, Daigaku-machi 2-7, Takatsuki, Osaka 569-8686 Japan
| | - Toshiaki Minami
- Department of Anesthesiology, Osaka Medical College, Daigaku-machi 2-7, Takatsuki, Osaka 569-8686 Japan
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Zhang JQ, Xue FS, Meng FM, Liu GP. Comparing video and direct laryngoscopes for pediatric intubation during cardiopulmonary resuscitation. Am J Emerg Med 2015; 33:1313-4. [PMID: 26081412 DOI: 10.1016/j.ajem.2015.05.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 05/26/2015] [Indexed: 11/25/2022] Open
Affiliation(s)
- Jia-Qiang Zhang
- Department of Anesthesiology, Henan Provincial People's Hospital of Zhengzhou University, Zhengzhou 450003, People's Republic of China
| | - Fu-Shan Xue
- Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100144, People's Republic of China.
| | - Fan-Min Meng
- Department of Anesthesiology, Henan Provincial People's Hospital of Zhengzhou University, Zhengzhou 450003, People's Republic of China
| | - Gao-Pu Liu
- Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100144, People's Republic of China
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Comparison of Pentax-AWS Airwayscope and Glidescope for Infant Tracheal Intubation by Anesthesiologists during Cardiopulmonary Arrest Simulation: A Randomized Crossover Trial. BIOMED RESEARCH INTERNATIONAL 2015; 2015:190163. [PMID: 26161388 PMCID: PMC4486488 DOI: 10.1155/2015/190163] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 01/06/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Recent guidelines for infant cardiopulmonary resuscitation emphasize that all rescuers should minimize interruption of chest compressions, even for endotracheal intubation. We compared the utility of the Pentax-AWS Airwayscope (AWS) with the Glidescope (GS) during chest compressions on an infant manikin. METHODS Twenty-four anesthesiologists with more than two years of experience performed tracheal intubation on an infant manikin using the AWS and GS, with or without chest compressions. RESULTS In GS trials, none of the participants failed without compressions, while three failed with compressions. In AWS trials, all participants succeeded regardless of chest compressions. Intubation time was significantly longer with chest compressions with the GS (P < 0.05), but not with the AWS. Difficulty of operation on a visual analog scale (VAS) for laryngoscopy did not increase significantly with chest compressions with either the GS or the AWS, while the VAS for tube passage through the glottis increased with compressions with the GS, but not with the AWS. CONCLUSION We conclude that in infant simulations managed by anesthesiologists, the AWS performed better than the GS for endotracheal intubation with chest compressions.
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Comparison of McGrath and Pentax-AWS Airwayscope for tracheal intubation by anaesthesiologists during chest compression in a manikin. Eur J Anaesthesiol 2015; 32:442-3. [DOI: 10.1097/eja.0000000000000185] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Szarpak Ł, Karczewska K, Czyżewski Ł, Kurowski A. A randomized comparison of the Laryngoscope with Fiber Optic Reusable Flexible Tip English Macintosh blade to the conventional Macintosh laryngoscope for intubation in simulated easy and difficult child airway with chest compression scenarios. Am J Emerg Med 2015; 33:951-6. [PMID: 25936475 DOI: 10.1016/j.ajem.2015.04.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 03/31/2015] [Accepted: 04/08/2015] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION We hypothesized that the Laryngoscope with Fiber Optic Reusable Flexible Tip English Macintosh blade (TMAC) is beneficial for the intubation of child manikins while performing cardiopulmonary resuscitation (CPR). In the present study, we evaluated the effectiveness of the conventional Macintosh laryngoscope (MAC) and TMAC in 3 simulated CPR scenarios. METHODS A randomized crossover simulation trial was designed. One hundred seven paramedics intubated the trachea of a PediaSIM CPR training manikin (FCAE HealthCare, Sarasota, FL) using the MAC and TMAC in a normal airway scenario (scenario A), normal airway with chest compression scenario (scenario B), and difficult airway with chest compression scenario (scenario C). The participants were directed to make a maximum of 3 attempts in each scenario. The success rate, time required for intubation, Cormack-Lehane grade, dental compression, and the ease of intubation were measured. RESULTS The median time of intubation with MAC and TMAC in scenario A was 19.6 (interquartile range [IQR], 18-23) vs 19 (IQR, 16.2-21.8); in scenario B, 29.5 (IQR, 25-31) vs 26 (IQR, 23.5-29) seconds; and in scenario C, 38 (IQR, 32.5-45) vs 29 (IQR, 25-31) seconds, respectively. The overall efficacy for each of the scenarios was as follows: in scenario A, it was 100% vs 100%; in scenario B, it was 79.4% vs 100% (P = .007); and in scenario C, it was 68.2% vs 90.7% (P < .001), respectively. CONCLUSIONS The TMAC seems to be a superior intubating device compared with the conventional MAC when used in simulated normal and difficult child airway with chest compression scenarios. Future studies should explore the efficacy of TMAC in pediatric clinical emergency settings.
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Affiliation(s)
- Łukasz Szarpak
- Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Karczewska
- Anesthesiology and Intensive Care Unit, Mazovian Regional Hospital, Radom, Poland.
| | - Łukasz Czyżewski
- Department of Nephrologic Nursing, Medical University of Warsaw, Warsaw, Poland; Department of Anesthesiology, Cardinal Wyszynski National Institute of Cardiology, Warsaw, Poland
| | - Andrzej Kurowski
- Department of Anesthesiology, Cardinal Wyszynski National Institute of Cardiology, Warsaw, Poland
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Nakao K, Komasawa N, Kusaka Y, Minami T. Rapid-Sequence Intubation in the Left-Lateral Tilt Position in a Pregnant Woman with Premature Placental Abruption Utilizing a Videolaryngoscope. AJP Rep 2015. [PMID: 26199794 PMCID: PMC4502628 DOI: 10.1055/s-0034-1544109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Case A 24-year-old pregnant woman was admitted to our hospital with decreased fetal heart rate. Obstetric examination revealed premature placental abruption; emergent caesarean section was planned under general anesthesia. On entering the operating room, the patient showed severe vital sign deterioration (blood pressure, 75/45 mm Hg; heart rate, 142 beats per minute). As left uterine displacement may worsen the premature placental abruption, the patient was placed in the left-lateral tilt position by rotating the operating table to release compression on the inferior vena cava by theuterus. To avoid circulatory collapse, rapid-sequence intubation was performed in this position. Tracheal intubation was performed with the Pentax-AWS Airwayscope (AWS videolaryngoscope, AWS; HOYA, Japan) to obtain a good laryngeal view and minimize stress from laryngoscopy. After sufficient oxygenation, 120 mg of thiopental was administered. A second anesthesiologist performed cricoid pressure and 50 mg of rocuronium was administered after confirming loss of consciousness. This was followed by insertion of the AWS with a thin intlock into the mouth. Tracheal intubation was performed uneventfully. Discussion Rapid-sequence intubation in the left-lateral tilted position with the AWS videolaryngoscope may be beneficial for pregnant women with vital sign deterioration.
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Affiliation(s)
- Kenta Nakao
- Department of Anesthesiology, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Nobuyasu Komasawa
- Department of Anesthesiology, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Yusuke Kusaka
- Department of Anesthesiology, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Toshiaki Minami
- Department of Anesthesiology, Osaka Medical College, Takatsuki, Osaka, Japan
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Lee DW, Kang MJ, Kim YH, Lee JH, Cho KW, Kim YW, Cho JH, Kim YS, Hong CK, Hwang SY. Performance of intubation with 4 different airway devices by unskilled rescuers: manikin study. Am J Emerg Med 2015; 33:691-6. [PMID: 25800412 DOI: 10.1016/j.ajem.2015.03.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 03/03/2015] [Accepted: 03/04/2015] [Indexed: 10/23/2022] Open
Abstract
INTRODUCTION This study was designed to compare the performances of 4 airway devices in achieving successful ventilation. METHODS A randomized crossover trial was conducted to evaluate 4 airway devices: laryngeal mask airway (LMA), i-gel (iGEL), PENTAX Airway Scope (AWS), and Macintosh laryngoscope (MCL). Thirty-eight unskilled rescuers performed intubation on a manikin during chest compressions in normal and difficult airway scenarios. The time to ventilation, intubation success rate, and difficulty of intubation were measured. RESULTS The time to ventilation of the airway devices in the normal scenario had a median value of 8.8 seconds (interquartile range, 7.3-10.5 seconds) for iGEL, 16.1 seconds (13.9-19.3 seconds) for LMA, 30.6 seconds (24.6-37.6 seconds) for AWS, and 35.0 seconds (29.5-45.9 seconds) for MCL. In the difficult airway scenario, the respective time to ventilation was 8.6 seconds (7.8-10.0 seconds), 15.3 seconds (14.3-20.2 seconds), 29.4 seconds (25.7-36.3 seconds) and 59.0 seconds (46.1-103.3 seconds). The success rates were 100% and 100% for LMA, 100% and 100% for iGEL, 97.4% and 94.7% for AWS, and 78.9% and 47.4% for MCL in the normal and difficult airway scenarios. The difficulties of intubation expressed as numerical rating scale were 2.0 and 2.0 (median values) for LMA, 1.0 and 2.0 for iGEL, 3.0 and 3.0 for AWS, and 4.0 and 5.0 for MCL in the normal and difficult airway scenarios, respectively. CONCLUSION With novice intubators who were unfamiliar with the airway devices, the LMA, iGEL, and AWS were superior to the MCL for establishing an airway without interruption of chest compressions in a manikin study. Intubation with the iGEL was faster and easier than with the other airway devices.
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Affiliation(s)
- Dong Woo Lee
- Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Mun Ju Kang
- Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Yong Hwan Kim
- Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Jun Ho Lee
- Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Kwang Won Cho
- Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Yang Weon Kim
- Department of Emergency Medicine, Inje University, Busan Paik Hospital, Busan, Republic of Korea
| | - Jun Hwi Cho
- Department of Emergency Medicine, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | - Young Sik Kim
- Department of Emergency Medicine, Bundang Jesaeng General Hospital, Seongnam, Republic of Korea
| | - Chong Kun Hong
- Department of Emergency Medicine, Bundang Jesaeng General Hospital, Seongnam, Republic of Korea
| | - Seong Youn Hwang
- Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
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Szarpak Ł, Czyżewski Ł, Kurowski A. Comparison of the Pentax, Truview, GlideScope, and the Miller laryngoscope for child intubation during resuscitation. Am J Emerg Med 2015; 33:391-5. [DOI: 10.1016/j.ajem.2014.12.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 12/10/2014] [Accepted: 12/12/2014] [Indexed: 11/30/2022] Open
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Komasawa N, Fujiwara S, Miyazaki S, Ohchi F, Minami T. Shifts in Endotracheal Tube Position Due to Chest Compressions: A Simulation Comparison by Fixation Method. J Emerg Med 2015; 48:241-6. [DOI: 10.1016/j.jemermed.2014.06.064] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 01/15/2014] [Accepted: 06/30/2014] [Indexed: 11/29/2022]
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Komasawa N, Nishihara I, Tatsumi S, Minami T. Does prewarming the i-gel supraglottic airway device fit the larynx better compared to keeping it at room temperature for non-paralysed, sedated patients: a randomised controlled trial. BMJ Open 2015; 5:e006653. [PMID: 25586372 PMCID: PMC4298088 DOI: 10.1136/bmjopen-2014-006653] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE This study aimed to test the hypothesis that the i-gel supraglottic airway device would fit the larynx and provide better sealing pressure if prewarmed to 42°C relative to the device kept at room temperature in non-paralysed, sedated patients. METHODS A total of 74 adult patients were assigned to the warm (i-gel prewarmed to 42°C; W group; 37 patients) or the control (i-gel kept at room temperature; C group; 37 patients) groups. Anaesthesia was induced with propofol and fentanyl. The i-gel was prewarmed to 42°C for 30 min before insertion in the W group, but kept at room temperature (approximately 23°C) for the C group. The number of attempts made until successful insertion and sealing pressure were compared between the two groups. RESULTS Insertion was successful with one attempt in 35 cases each for the W and C groups. Two attempts were needed in two cases for the W group and one case for the C group. There was one failed attempt in the C group, but none in the W group. None of the differences between the two groups were significant (p=0.51). Sealing pressure was slightly, but not significantly, higher in the W group than in the C group (W group 22.6±6.1 cm H2O; C group 20.7±6.1 cm H2O; p=0.15). CONCLUSIONS Prewarming of the i-gel to 42°C did not increase the success rate of insertion, nor did it significantly increase sealing pressure in anaesthetised, non-paralysed patients. Our data suggest that we can keep the i-gel at room temperature for emergency airway management for non-paralysed, sedated patients. TRIAL REGISTRATION NUMBER University Medical Information Network, Japan 000012287.
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Affiliation(s)
- Nobuyasu Komasawa
- Department of Anaesthesiology, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Isao Nishihara
- Department of Anaesthesiology, Hokusetsu General Hospital, Takatsuki, Osaka, Japan
| | - Shinichi Tatsumi
- Department of Anaesthesiology, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Toshiaki Minami
- Department of Anaesthesiology, Osaka Medical College, Takatsuki, Osaka, Japan
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Kohama H, Komasawa N, Ueki R, Kaminoh Y, Nishi SI. Simulation analysis of three intubating supraglottic devices during infant chest compression. Pediatr Int 2015; 57:180-2. [PMID: 25711262 DOI: 10.1111/ped.12541] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 09/21/2014] [Accepted: 10/29/2014] [Indexed: 11/27/2022]
Abstract
Current guidelines for pediatric cardiopulmonary resuscitation suggest that supraglottic devices are alternatives for tracheal intubation with minimal interruption of chest compression. We examined the utility of three intubating supraglottic devices, air-Q® (air-Q), Ambu® aura-i (aura-i), and i-gel® (i-gel), utilizing manikin simulation. Twenty-two novice physicians performed securing of airway on an infant manikin with the three devices. We measured the rate of success on ventilation and the insertion time with or without chest compression. Successful ventilation rate did not significantly decrease with chest compression in the three devices (without chest compression: air-Q, 21/22; aura-i, 20/22; i-gel, 20/22, during chest compression: air-Q, 20/22; aura-i, 20/22; i-gel, 18/22). The insertion time with air-Q and aura-i did not extend significantly for chest compression. In contrast, the insertion time with i-gel was significantly extended in chest compression (P < 0.05). Air-Q and aura-i are more useful for airway management during chest compression than i-gel.
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Affiliation(s)
- Hanako Kohama
- Division of Intensive Care Unit, Hyogo College of Medicine, Hyogo, Japan
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Okada D, Komasawa N, Fujiwara S, Minami T. Comparison of tube-guided and guideless videolaryngoscope for tracheal intubation during chest compression in a manikin: a randomized crossover trial. J Anesth 2014; 29:331-337. [DOI: 10.1007/s00540-014-1936-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 10/15/2014] [Indexed: 11/30/2022]
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Kitano M, Komasawa N, Fujiwara S, Minami T. Comparison of positional shift of supraglottic devices resulting from chest compressions: simulation using a manikin and automated chest compression system. Acute Med Surg 2014; 2:134-137. [PMID: 29123709 DOI: 10.1002/ams2.85] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 08/19/2014] [Indexed: 11/10/2022] Open
Abstract
Background The American Heart Association 2010 Guidelines for Resuscitation suggest the use of supraglottic devices as an alternative to tracheal intubation during cardiopulmonary resuscitation. This study aimed to evaluate supraglottic device displacement and the effect of tape fixation by simulation with a manikin and automated chest compression system. Methods We placed eight supraglottic devices (ProSeal, i-gel, Classic, Soft Seal, Fastrack, Supreme, Ambu-aura-i, air-Q) into an advanced life support simulator, and compared no fixation and Durapore tape fixation conditions. After 5 min of automated chest compressions, positional shift of the supraglottic devices was measured. A total of five trials were carried out in each setting. Statistical analysis was carried out with two-way repeated measures anova. P < 0.05 was considered significant. Results Positional shift after 5 min of chest compressions were as follows: ProSeal, 0.68 ± 0.26 cm; i-gel, 0.50 ± 0.16 cm; Classic, 0.36 ± 0.15 cm; Soft Seal, 0.32 ± 0.08 cm; Fastrack, 0.20 ± 0.07 cm; Supreme, 0.20 ± 0.07 cm; Ambu-aura-i, 0.18 ± 0.08 cm; and air-Q, 0.12 ± 0.04 cm. Positional shift was larger with the ProSeal and i-gel compared with any of the other six supraglottic devices (P < 0.05). Conversely, positional shift was significantly smaller with the air-Q than the other supraglottic devices (P < 0.05). Tape fixation reduced positional shift for all supraglottic devices, with a significant reduction observed with ProSeal, i-gel, Classic, and Soft Seal. Conclusion Simulation analysis revealed that positional shift of air-Q by chest compressions is smaller than those of seven other supraglottic devices.
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Affiliation(s)
- Manabu Kitano
- Department of Anesthesiology Osaka Medical College Osaka Japan
| | | | | | - Toshiaki Minami
- Department of Anesthesiology Osaka Medical College Osaka Japan
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Goto T, Koyama Y, Kondo T, Tsugawa Y, Hasegawa K. A comparison of the force applied on oral structures during intubation attempts between the Pentax-AWS airwayscope and the Macintosh laryngoscope: a high-fidelity simulator-based study. BMJ Open 2014; 4:e006416. [PMID: 25296656 PMCID: PMC4194748 DOI: 10.1136/bmjopen-2014-006416] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE We sought to determine whether the use of Pentax-AWS Airwayscope (AWS) applied less force on oral structures during intubation attempts than a conventional direct laryngoscope (DL). DESIGN Prospective cross-over study. PARTICIPANTS A total of 37 physicians (9 transitional-year residents, 20 emergency medicine residents and 8 emergency physicians) were enrolled. INTERVENTIONS We used four simulation scenarios according to the difficulty of intubation and devices and used a high-fidelity simulator to quantify the forces applied on the oral structures. OUTCOME MEASURES Primary outcomes were the maximum force applied on the maxillary incisors and tongue. Other outcomes of interest were time to intubation and glottic view during intubation attempts. RESULTS The maximum force applied on the maxillary incisors in the normal airway scenario was higher with the use of AWS than that with DL (107 newton (N) vs 77 N, p=0.02). By contrast, the force in the difficult airway scenario was significantly lower with the use of AWS than that of the DL (89 N vs 183 N, p<0.01). Likewise, the force applied on the tongue was significantly lower with the use of AWS than the use of DL in both airway scenarios (11 N vs 27 N, p<0.001 in the normal airway scenario; 12 N vs 40 N, p<0.01 in the difficult airway scenario). CONCLUSIONS The use of AWS during intubation attempts was associated with decreased forces applied to oral structures in the simulated difficult airway scenario.
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Affiliation(s)
- Tadahiro Goto
- Department of Emergency Medicine, University of Fukui Hospital, Fukui, Japan
| | - Yasuaki Koyama
- Department of Emergency and Critical Care Medicine, University of Tsukuba Hospital, Ibaraki, Japan
| | - Takashiro Kondo
- Department of Healthcare Epidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Yusuke Tsugawa
- Harvard Interfaculty Initiative in Health Policy, Harvard University, Cambridge, Massachusetts, USA
| | - Kohei Hasegawa
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Kotera A, Irie H, Iwashita S, Taniguchi J, Kasaoka S, Kinoshita Y. Comparison of the utility of the Pentax Airway Scope (AWS) with that of the conventional Macintosh laryngoscope during chest compression: is the AWS an easy-to-use device for a novice? Acute Med Surg 2014; 1:163-169. [DOI: 10.1002/ams2.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 02/05/2014] [Indexed: 11/10/2022] Open
Affiliation(s)
- Atsushi Kotera
- Department of Emergency and General Medicine; Kumamoto University Hospital; Kumamoto Japan
| | - Hiroki Irie
- Department of Emergency and General Medicine; Kumamoto University Hospital; Kumamoto Japan
| | - Shinsuke Iwashita
- Department of Emergency and General Medicine; Kumamoto University Hospital; Kumamoto Japan
| | - Junichi Taniguchi
- Department of Emergency and General Medicine; Kumamoto University Hospital; Kumamoto Japan
| | - Shunji Kasaoka
- Department of Emergency and General Medicine; Kumamoto University Hospital; Kumamoto Japan
| | - Yoshihiro Kinoshita
- Department of Intensive Care Medicine; Kumamoto University Hospital; Kumamoto Japan
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Should videolaryngoscopes be as first choice for endotracheal intubation during cardiorespiratory resuscitation?: Re: Park SO, et al. Feasibility of the video-laryngoscope (GlideScope®) for endotracheal intubation during uninterrupted chest compressions in actual advanced life support: a clinical observational study in an urban emergency department. Resuscitation 84 (2013) 1233-1237. Resuscitation 2014; 85:e69. [PMID: 24572483 DOI: 10.1016/j.resuscitation.2014.01.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 01/15/2014] [Indexed: 11/21/2022]
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Komasawa N, Ueki R, Kaminoh Y, Nishi SI. Evaluation of chest compression effect on airway management with air-Q®, aura-i®, i-gel®, and Fastrack® intubating supraglottic devices by novice physicians: a randomized crossover simulation study. J Anesth 2014; 28:676-80. [DOI: 10.1007/s00540-014-1802-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Accepted: 02/01/2014] [Indexed: 10/25/2022]
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Kohama H, Komasawa N, Ueki R, Yamamoto N, Tashiro C, Kaminoh Y, Nishi SI. Utility of the Pentax-AWS Airwayscope and Macintosh laryngoscope for airway management during chest compressions in 27° left-lateral tilt: a manikin simulation study of maternal cardiopulmonary resuscitation. J Anesth 2013; 27:671-5. [DOI: 10.1007/s00540-013-1619-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 04/12/2013] [Indexed: 11/29/2022]
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Kohama H, Komasawa N, Ueki R, Itani M, Nishi SI, Kaminoh Y. Addition of a video camera system improves the ease of Airtraq® tracheal intubation during chest compression. J Anesth 2011; 26:296-8. [DOI: 10.1007/s00540-011-1301-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Accepted: 11/28/2011] [Indexed: 10/14/2022]
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Komasawa N, Ueki R, Yamamoto N, Atagi K, Nishi SI, Kaminoh Y, Tashiro C. Comparison of air-Q(®) and Soft Seal(®) laryngeal mask for airway management by novice doctors during infant chest compression: a manikin study. Resuscitation 2011; 83:365-8. [PMID: 21958927 DOI: 10.1016/j.resuscitation.2011.08.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2011] [Revised: 08/13/2011] [Accepted: 08/19/2011] [Indexed: 10/17/2022]
Abstract
BACKGROUND Recent resuscitation guidelines for infant cardiopulmonary resuscitation (CPR) emphasise that rescuers should minimise the interruption of chest compressions. To that end, supraglottic devices such as laryngeal mask airways (LMAs) are suggested as a backup for airway management during infant CPR. We therefore compared the utility of the air-Q(®) LMA (air-Q) with that of the Soft Seal(®) LMA (Soft Seal) for infant CPR in an infant manikin. METHODS Twenty-four novice doctors in the anaesthesia department performed insertion and ventilation with air-Q and Soft Seal on an infant manikin with or without chest compression. RESULTS Two doctors failed to insert the Soft Seal without chest compression, while nine failed during chest compression (P<0.05). However, only one doctor failed to insert the air-Q without chest compression, and two doctors failed during chest compression. Insertion time was not significantly increased with chest compression using either device. Insertion time during chest compression was significantly shorter for the air-Q than for the Soft Seal (P<0.05). The visual analogue scale (VAS) was used to evaluate difficulty of use (0mm (extremely easy) to 100mm (extremely difficult)). VAS scores did not change significantly by the addition of chest compression with either device; however, VAS scores during chest compression were significantly higher with Soft Seal than with the air-Q device. CONCLUSION We conclude that novice doctors find the air-Q easier to use than Soft Seal for emergency airway management during chest compression in infants, in an infant manikin.
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Affiliation(s)
- Nobuyasu Komasawa
- Department of Anesthesiology, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya, Hyogo 663-8501, Japan.
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Komasawa N, Ueki R, Kohama H, Nishi SI, Kaminoh Y. Comparison of Pentax-AWS Airwayscope video laryngoscope, Airtraq optic laryngoscope, and Macintosh laryngoscope during cardiopulmonary resuscitation under cervical stabilization: a manikin study. J Anesth 2011; 25:898-903. [DOI: 10.1007/s00540-011-1218-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Accepted: 08/16/2011] [Indexed: 02/07/2023]
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Tracheal intubation during chest compressions using Pentax-AWS®, GlideScope®, and Macintosh laryngoscope: a randomized crossover trial using a mannequin. Can J Anaesth 2011; 58:733-9. [DOI: 10.1007/s12630-011-9524-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Accepted: 05/16/2011] [Indexed: 11/26/2022] Open
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Ikeno S, Nagano M, Tanaka S, Nishimura C, Kawamata T, Kawamata M. Gastric tube insertion under visual control with the use of the Pentax-AWS®. J Anesth 2011; 25:475-6. [DOI: 10.1007/s00540-011-1133-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Accepted: 03/16/2011] [Indexed: 12/01/2022]
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Komasawa N, Ueki R, Fujii A, Samma A, Nakagawa M, Nishi SI, Kaminoh Y. Comparison of Laryngeal Mask Supreme® and Soft Seal® for airway management in several positions. J Anesth 2011; 25:535-9. [DOI: 10.1007/s00540-011-1145-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Accepted: 03/24/2011] [Indexed: 12/01/2022]
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Komasawa N, Atagi K, Ueki R, Nishi SI, Kaminoh Y, Tashiro C. Comparison of optic laryngoscope Airtraq(®) and Miller laryngoscope for tracheal intubation during infant cardiopulmonary resuscitation. Resuscitation 2011; 82:736-9. [PMID: 21349626 DOI: 10.1016/j.resuscitation.2011.01.026] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Revised: 01/22/2011] [Accepted: 01/24/2011] [Indexed: 11/24/2022]
Abstract
BACKGROUND Recent resuscitation guidelines for infant cardiopulmonary resuscitation (CPR) emphasize that all rescuers should minimize interruption of chest compressions, even for endotracheal intubation. We compared the utility of the Miller laryngoscope (Mil) with Airtraq (ATQ) during chest compression in an infant manikin. METHODS Twenty staff doctors in intensive care and emergency medicine performed tracheal intubation on an infant manikin with Mil and ATQ with or without chest compression. RESULTS In Mil trials, no participants failed without chest compression, but 6 of them failed during chest compression (P < 0.05). In ATQ trials, all participants successfully secured the airway regardless of chest compression. Intubation time was significantly lengthened due to chest compression in Mil trials, but not in ATQ trials. The visual analog scale (VAS) for laryngoscope image did not significantly change due to chest compression for ATQ or Mil trials. In contrast, chest compression worsened VAS scores for tube passage through the glottis in Mil trials, but not in ATQ trials. CONCLUSION We conclude that ATQ performed better than Mil for endotracheal intubation during chest compression in infant simulations managed by expert doctors.
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Affiliation(s)
- Nobuyasu Komasawa
- Department of Anesthesiology, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya, Hyogo 663-8501, Japan.
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Comparison of Supreme(®) and Soft Seal(®) laryngeal masks for airway management during cardiopulmonary resuscitation in novice doctors: a manikin study. J Anesth 2010; 25:98-103. [PMID: 21120542 DOI: 10.1007/s00540-010-1054-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2010] [Accepted: 11/10/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE In the 2005 American Heart Association (AHA) guidelines, the laryngeal mask (LMA) was proposed as an alternative to tracheal intubation for cardiopulmonary resuscitation (CPR). We compared the utility of a newly developed LMA, the Supreme(®) (Supreme), with a conventional LMA, the Soft Seal(®) (Soft Seal). METHODS A total of 19 novice doctors in our anesthesia department performed insertion of the Supreme or Soft Seal on a manikin with or without chest compression. Insertion time and number of attempts for successful ventilation were measured. After successful ventilation, the amount of air entering the stomach and maximum ventilation pressure were measured. The subjective difficulty of using the devices was also measured. RESULTS The ventilation success rate of first insertion did not differ between the Supreme and Soft Seal without chest compression. However, the success rate was significantly lower with the Soft Seal than the Supreme during chest compression. Insertion time was lengthened by chest compression with the Soft Seal, but not with the Supreme. Maximum ventilation pressure was higher with the Supreme than the Soft Seal. The amount of air entering the stomach was significantly lower with the Supreme than the Soft Seal. The Supreme also scored better than the Soft Seal on a visual analog scale of subjective difficulty in insertion. CONCLUSIONS The Supreme is an effective device for airway management during chest compression.
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