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Morioka D, Sagisaka R, Nakagawa K, Takahashi H, Tanaka H. Effect of timing of advanced life support on out-of-hospital cardiac arrests at home. Am J Emerg Med 2024; 82:94-100. [PMID: 38848664 DOI: 10.1016/j.ajem.2024.05.021] [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: 01/07/2024] [Revised: 04/14/2024] [Accepted: 05/24/2024] [Indexed: 06/09/2024] Open
Abstract
AIM In cases of out-of-hospital cardiac arrests (OHCA) occurring at home, Japanese emergency medical services personnel decide whether to provide treatment on the scene or during transport based on their judgment. This study aimed to evaluate the association between the timing of advanced life support (ALS) (i.e., endotracheal intubation [ETI] or adrenaline administration) for OHCA at home and prognosis. METHOD This retrospective cohort study used data from the Japan Utstein Registry and emergency transport data collected from patients who underwent pre-hospital ETI (n = 6806) and received adrenaline (n = 22,636) between 2016 and 2019. The timing of ETI or adrenaline administration was determined as "on the scene" or "in the ambulance." Multiple logistic regression analysis was used to estimate the association among the timing of ALS implementation, pre-hospital return of spontaneous circulation (ROSC), and survival at 1 month. RESULT ETI on the scene was significantly positively associated with pre-hospital ROSC (adjusted odds ratio [AOR], 1.81; 95% confidence interval [CI], 1.57-2.09) and survival at 1 month (AOR, 1.81; 95% CI, 1.47-2.23). Adrenaline administration on the scene was significantly positively associated with pre-hospital ROSC (AOR, 2.51; 95% CI, 2.33-2.70) and survival at 1 month (AOR, 2.13; 95% CI, 1.89-2.40). CONCLUSION Our analysis suggests performing ALS on the scene was associated with pre-hospital ROSC and survival at 1 month. Further efforts are needed to increase the rate of ALS implementation on the scene by emergency life-saving technicians.
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Affiliation(s)
- Daigo Morioka
- Faculty of Emergency Medical Science, School of Health Science and Medical Care, Meiji University of Integrative Medicine, Kyoto, Japan; Graduate School of Emergency Medical System, Kokushikan University, Tokyo, Japan.
| | - Ryo Sagisaka
- Graduate School of Emergency Medical System, Kokushikan University, Tokyo, Japan; Research Institute of Disaster Management and Emergency Medical System, Kokushikan University, Tokyo, Japan
| | - Koshi Nakagawa
- Department of Integrated Science and Engineering for Sustainable Societies, Faculty of Science and Engineering, Chuo University, Tokyo, Japan
| | - Hiroyuki Takahashi
- Graduate School of Emergency Medical System, Kokushikan University, Tokyo, Japan
| | - Hideharu Tanaka
- Graduate School of Emergency Medical System, Kokushikan University, Tokyo, Japan
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Masumori Y, Inoue S, Seino Y, Konishi M, Nishikawa H. Glottis Recognition Software Development Using Artificial Intelligence. Cureus 2024; 16:e61464. [PMID: 38953088 PMCID: PMC11215229 DOI: 10.7759/cureus.61464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2024] [Indexed: 07/03/2024] Open
Abstract
The use of video laryngoscopes has enhanced the visualization of the vocal cords, thereby improving the accessibility of tracheal intubation. Employing artificial intelligence (AI) to recognize images obtained through video laryngoscopy, particularly when marking the epiglottis and vocal cords, may elucidate anatomical structures and enhance anatomical comprehension of anatomy. This study investigates the ability of an AI model to accurately identify the glottis in video laryngoscope images captured from a manikin. Tracheal intubation was conducted on a manikin using a bronchoscope with recording capabilities, and image data of the glottis was gathered for creating an AI model. Data preprocessing and annotation of the vocal cords, epiglottis, and glottis were performed, and human annotation of the vocal cords, epiglottis, and glottis was carried out. Based on the AI's determinations, anatomical structures were color-coded for identification. The recognition accuracy of the epiglottis and vocal cords recognized by the AI model was 0.9516, which was over 95%. The AI successfully marked the glottis, epiglottis, and vocal cords during the tracheal intubation process. These markings significantly aided in the visual identification of the respective structures with an accuracy of more than 95%. The AI demonstrated the ability to recognize the epiglottis, vocal cords, and glottis using an image recognition model of a manikin.
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Affiliation(s)
- Yasushi Masumori
- Anesthesiology, St. Marianna University School of Medicine, Kawasaki, JPN
| | - Soichiro Inoue
- Anesthesiology, St. Marianna University School of Medicine, Kawasaki, JPN
| | - Yusuke Seino
- Anesthesiology, St. Marianna University School of Medicine, Kawasaki, JPN
| | - Mamoru Konishi
- Artificial Intelligence, Focus Systems Corporation, Tokyo, JPN
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Khan MJ, Karmakar A. Emerging Robotic Innovations and Artificial Intelligence in Endotracheal Intubation and Airway Management: Current State of the Art. Cureus 2023; 15:e42625. [PMID: 37641747 PMCID: PMC10460626 DOI: 10.7759/cureus.42625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2023] [Indexed: 08/31/2023] Open
Abstract
Robotic sciences have rapidly advanced and revolutionized various aspects of medicine, including the field of airway management. Robotic endotracheal intubation is an innovative method that utilizes robotic systems to aid in the accurate placement of an endotracheal tube within the trachea. This cutting-edge technique shows great promise in improving procedural precision and ensuring patient safety. In this comprehensive overview, we delve into the present status of robotic-assisted endotracheal intubation, examining its advantages, obstacles, and the potential implications it holds for the future. In addition, this review encompasses a comprehensive analysis of the existing literature and references on recent advances in robotic technology and artificial intelligence related to airway management.
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Affiliation(s)
| | - Arunabha Karmakar
- Anesthesiology and Perioperative Medicine, Hamad Medical Corporation, Doha, QAT
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Kent ME, Sciavolino BM, Blickley ZJ, Pasichow SH. Video Laryngoscopy versus Direct Laryngoscopy for Orotracheal Intubation in the Out-of-Hospital Environment: A Systematic Review and Meta-Analysis. PREHOSP EMERG CARE 2023; 28:221-230. [PMID: 37256300 DOI: 10.1080/10903127.2023.2219727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/26/2023] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To determine the effect of video and direct laryngoscopy on first-pass success rates for out-of-hospital orotracheal intubation. METHODS MEDLINE, Embase, and Cochrane databases were searched from inception to January 2023. Out-of-hospital studies comparing video and direct laryngoscopy on either first-pass or overall intubation success were included. A random effects meta-analysis was performed with a primary outcome of first-pass success stratified by clinician type and laryngoscope blade geometry. The secondary outcomes were overall intubation success stratified by clinician type, and intubation time. All hypotheses and subgroup analyses were determined a priori. RESULTS Twenty-five studies involving 35,489 intubations met inclusion criteria. Substantial heterogeneity (>75%) precluded reporting point estimates for nearly all analyses. For our primary outcome, video laryngoscopy was associated with improved first-pass success in 3/5 physician studies, 4/6 critical care paramedic/registered nurse studies, and 7/10 paramedic studies. Video laryngoscope devices with Macintosh blade geometry were associated with improved first-pass success in 7/10 studies, while devices with hyperangulated geometry were associated with improved first-pass success in 3/7 studies. Overall intubation success was greater with video laryngoscopy in 2/6 studies in the physician subgroup and 9/10 studies in the paramedic subgroup. Video laryngoscopy was not associated with overall intubation success among critical care paramedics/nurses (OR = 1.89, 0.96 to 3.72, I2 = 34%). Lastly, 4/5 studies found video laryngoscopy to be associated with longer intubation times. CONCLUSIONS We found substantial heterogeneity among out-of-hospital studies comparing video laryngoscopy to direct laryngoscopy on first-pass success, overall success, or intubation time. This heterogeneity was not explained with stratification by study design, clinician type, video laryngoscope blade geometry, or leave-one-out meta-analysis. A majority of studies showed that video laryngoscopy was associated with improved first pass success in all subgroups, but only for paramedics and not physicians when looking at overall success. This improvement was more common in studies that used Macintosh blades than those that used hyperangulated blades. Future research should explore the heterogeneity identified in our analysis with an emphasis on differences in training, clinical milieu, and specific video laryngoscope devices.
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Affiliation(s)
- Matthew E Kent
- Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | | | | | - Scott H Pasichow
- Division of Emergency Medical Services, Department of Emergency Medicine, Southern Illinois University School of Medicine, Springfield, Illinois, USA
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Phillips JP, Anger DJ, Rogerson MC, Myers LA, McCoy RG. Transitioning from Direct to Video Laryngoscopy during the COVID-19 Pandemic Was Associated with a Higher Endotracheal Intubation Success Rate. PREHOSP EMERG CARE 2023; 28:200-208. [PMID: 36730082 DOI: 10.1080/10903127.2023.2175087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 12/02/2022] [Accepted: 01/03/2023] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The objective of this study was to determine the effect of transitioning from direct laryngoscopy (DL) to video laryngoscopy (VL) on endotracheal intubation success overall and with enhanced precautions implemented during the COVID-19 pandemic. METHODS We examined electronic transport records from Mayo Clinic Ambulance Service, a large advanced life support (ALS) provider serving rural, suburban, and urban areas in Minnesota and Wisconsin, USA. We determined the success of intubation attempts when using DL (March 10, 2018 to December 19, 2019), VL (December 20, 2019 to September 29, 2021), and VL with an enhanced COVID-19 guideline that restricted intubation to one attempt, performed by the most experienced clinician, who wore enhanced personal protective equipment (April 1 to December 18, 2020). Success rates at first attempt and after any attempt were assessed for association with type of laryngoscopy (VL vs DL) after adjusting for patient age group, patient weight, use of enhanced COVID-19 guideline, medical vs trauma patient, and ALS vs critical care clinician. A secondary analysis further adjusted for degree of glottic visualization. RESULTS We identified 895 intubation attempts using DL and 893 intubation attempts using VL, which included 382 VL intubation attempts using the enhanced COVID-19 guideline. Success on first intubation attempt was 69.2% for encounters with DL, 82.9% overall with VL, and 83.2% with VL and enhanced COVID-19 protocols (DL vs overall VL: p < 0.001; COVID-19 vs non-COVID VL: p = 0.86). In multivariable analysis, use of VL was associate with higher odds of successful intubation on first attempt (odds ratio, 2.28; 95%CI, 1.73-3.01; p < 0.001) and on any attempt (odds ratio, 2.16; 95%CI, 1.58-2.96; p < 0.001) compared with DL. Inclusion of glottic visualization in the model resulted in a nonsignificant association between laryngoscopy type and successful first intubation (p = 0.41) and a significant association with the degree of glottic visualization (p < 0.001). CONCLUSIONS VL is designed to improve glottic visualization. The use of VL by a large, U.S. multistate ALS ambulance service was associated with increased odds of successful first-pass and overall attempted intubation, which was mediated by better visualization of the glottis. COVID-19 protocols were not associated with success rates.
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Affiliation(s)
| | - Daniel J Anger
- Mayo Clinic Ambulance Service, Mayo Clinic, Rochester, Minnesota
| | | | - Lucas A Myers
- Mayo Clinic Ambulance Service, Mayo Clinic, Rochester, Minnesota
| | - Rozalina G McCoy
- Mayo Clinic Ambulance Service, Mayo Clinic, Rochester, Minnesota
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, Minnesota
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
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6
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Walker PW, Burdette M, Susi L, Guyette FX, Martin-Gill C. Association between First-pass Intubation Success and Enhanced PPE Use during the COVID-19 Pandemic. PREHOSP EMERG CARE 2023; 28:209-214. [PMID: 36780396 DOI: 10.1080/10903127.2023.2177366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/24/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVES We evaluated first-pass endotracheal intubation (ETI) success within the critical care transport (CCT) environment using a natural experiment created by the COVID-19 pandemic. Our primary objective was to evaluate if the use of personal protective equipment (PPE) or the COVID-19 time period was associated with differences in first-pass success rates of ETI within a large CCT system with a high baseline ETI first-pass success rate. We hypothesized that pandemic-related challenges would be associated with decreased first-pass success rates. METHODS We performed a retrospective before-after cohort study of airway management by CCT personnel relative to the COVID-19 pandemic. We used a mixed effects logistic regression to evaluate the association between enhanced PPE (N95 mask, eye protection) use and the pandemic time period on first-pass intubation success, while controlling for other factors potentially associated with intubation success. Variables in the final model included patient demographics (age, sex, and race), body mass index, medical category (trauma versus non-trauma), interfacility or scene response, blade size (Macintosh 3 versus 4), use of face mask, use of eye protection, and crew member length of service. RESULTS We identified 1279 cases involving intubation attempts on adult patients during the study period. A total of 1133 cases were included in the final analysis, with an overall first-pass success rate of 95.7% (96.4% pre-COVID-19 and 94.8% during COVID-19). In our final mixed effects logistic regression model, enhanced PPE use and the COVID-19 time period were not associated with first-pass intubation success rate. CONCLUSION In a large regional CCT system with a high ETI first-pass success rate, neither PPE use nor the COVID-19 time period were associated with differences in ETI first-pass success while controlling for relevant patient and operational factors. Other emergency medical services (EMS) systems may have encountered different effects of pandemic-related PPE use on intubation success rates. Further studies are needed to evaluate the influence of sustained use of enhanced PPE or changes in training or procedural experience on post-pandemic ETI first-pass success rates for non-CCT EMS clinicians.
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Affiliation(s)
- Philip W Walker
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Magdalena Burdette
- Statistical Consulting Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Laura Susi
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Francis X Guyette
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Christian Martin-Gill
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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7
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Reinert L, Herdtle S, Hohenstein C, Behringer W, Arrich J. Predictors for Prehospital First-Pass Intubation Success in Germany. J Clin Med 2022; 11:jcm11030887. [PMID: 35160336 PMCID: PMC8836538 DOI: 10.3390/jcm11030887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 02/01/2022] [Accepted: 02/05/2022] [Indexed: 12/04/2022] Open
Abstract
(1) Background: Endotracheal intubation in the prehospital setting is an important skill for emergency physicians, paramedics, and other members of the EMS providing airway management. Its success determines complications and patient mortality. The aim of this study was to find predictors for first-pass intubation success in the prehospital emergency setting. (2) The study was based on a retrospective analysis of a population-based registry of prehospital advanced airway management in Germany. Cases of endotracheal intubation by the emergency medical services in the cities of Tübingen and Jena between 2016 and 2019 were included. The outcome of interest was first-pass intubation success. Univariate and multivariable regression analysis were used to analyse the influence of predefined predictors, including the characteristics of patients, the intubating staff, and the clinical situation. (3) Results: A total of 308 patients were analysed. After adjustment for multiple confounders, the direct vocal cord view, a less favourable Cormack–Lehane classification, the general practitioner as medical specialty, and location and type of EMS were independent predictors for first-pass intubation success. (4) Conclusions: In physician-led emergency medical services, the laryngoscopic view, medical specialty, type of EMS, and career level are associated with FPS. The latter points towards the importance of experience and regular training in endotracheal intubation.
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Affiliation(s)
- Lukas Reinert
- Department of Emergency Medicine, Faculty of Medicine, Friedrich Schiller University Jena, 07747 Jena, Germany;
| | - Steffen Herdtle
- Department of Emergency Medicine, Hospital of Agatharied, 83734 Hausham, Germany;
| | - Christian Hohenstein
- Department of Emergency Medicine, Zentralklinik Bad Berka, 99438 Bad Berka, Germany;
| | - Wilhelm Behringer
- Department of Emergency Medicine, Medical University of Vienna, 1090 Wien, Austria;
| | - Jasmin Arrich
- Department of Emergency Medicine, Medical University of Vienna, 1090 Wien, Austria;
- Correspondence:
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Long-term intubation and high rate of tracheostomy in COVID-19 patients might determine an unprecedented increase of airway stenoses: a call to action from the European Laryngological Society. Eur Arch Otorhinolaryngol 2020; 278:1-7. [PMID: 32506145 PMCID: PMC7275663 DOI: 10.1007/s00405-020-06112-6] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 06/03/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The novel Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2, may need intensive care unit (ICU) admission in up to 12% of all positive cases for massive interstitial pneumonia, with possible long-term endotracheal intubation for mechanical ventilation and subsequent tracheostomy. The most common airway-related complications of such ICU maneuvers are laryngotracheal granulomas, webs, stenosis, malacia and, less commonly, tracheal necrosis with tracheo-esophageal or tracheo-arterial fistulae. MATERIALS AND METHODS This paper gathers the opinions of experts of the Laryngotracheal Stenosis Committee of the European Laryngological Society, with the aim of alerting the medical community about the possible rise in number of COVID-19-related laryngotracheal stenosis (LTS), and the aspiration of paving the way to a more rationale concentration of these cases within referral specialist airway centers. RESULTS A range of prevention strategies, diagnostic work-up, and therapeutic approaches are reported and framed within the COVID-19 pandemic context. CONCLUSIONS One of the most important roles of otolaryngologists when encountering airway-related signs and symptoms in patients with previous ICU hospitalization for COVID-19 is to maintain a high level of suspicion for LTS development, and share it with colleagues and other health care professionals. Such a condition requires specific expertise and should be comprehensively managed in tertiary referral centers.
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Risse J, Volberg C, Kratz T, Plöger B, Jerrentrup A, Pabst D, Kill C. Comparison of videolaryngoscopy and direct laryngoscopy by German paramedics during out-of-hospital cardiopulmonary resuscitation; an observational prospective study. BMC Emerg Med 2020; 20:22. [PMID: 32293276 PMCID: PMC7092671 DOI: 10.1186/s12873-020-00316-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 03/09/2020] [Indexed: 12/03/2022] Open
Abstract
Background Videolaryngoscopy (VL) has become a popular method of intubation (ETI). Although VL may facilitate ETI in less-experienced rescuers there are limited data available concerning ETI performed by paramedics during CPR. The goal was to evaluate the impact VL compared with DL on intubation success and glottic view during CPR performed by German paramedics. We investigated in an observational prospective study the superiority of VL by paramedics during CPR compared with direct laryngoscopy (DL). Methods In a single Emergency Medical Service (EMS) in Germany with in total 32 ambulances paramedics underwent an initial instruction from in endotracheal intubation (ETI) with GlideScope® (GVL) during resuscitation. The primary endpoint was good visibility of the glottis (Cormack-Lehane grading 1/2), and the secondary endpoint was successful intubation comparing GVL and DL. Results In total n = 97 patients were included, n = 69 with DL (n = 85 intubation attempts) and n = 28 VL (n = 37 intubation attempts). Videolaryngoscopy resulted in a significantly improved visualization of the larynx compared with DL. In the group using GVL, 82% rated visualization of the glottis as CL 1&2 versus 55% in the DL group (p = 0.02). Despite better visualization of the larynx, there was no statistically significant difference in successful ETI between GVL and DL (GVL 75% vs. DL 68.1%, p = 0.63). Conclusions We found no difference in Overall and First Pass Success (FPS) between GVL and DL during CPR by German paramedics despite better glottic visualization with GVL. Therefore, we conclude that education in VL should also focus on insertion of the endotracheal tube, considering the different procedures of GVL. Trial registration German Clinical Trial Register DRKS00020976, 27. February 2020 retrospectively registered.
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Affiliation(s)
- Joachim Risse
- Center of Emergency Medicine, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany.
| | - Christian Volberg
- Department of Anesthesiology and Intensive Care Medicine, Philipps-University Marburg, 35033, Marburg, Germany
| | - Thomas Kratz
- Department of Anesthesia and Intensive Care Medicine, 21240 Talant, Côte-d'Or, Dijon, France
| | - Birgit Plöger
- Department of Emergency Medicine, Philipps-University Marburg, 35033, Marburg, Germany
| | - Andreas Jerrentrup
- Department of Emergency Medicine, Philipps-University Marburg, 35033, Marburg, Germany
| | - Dirk Pabst
- Center of Emergency Medicine, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany
| | - Clemens Kill
- Center of Emergency Medicine, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany
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10
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Automated tracheal intubation in an airway manikin using a robotic endoscope: a proof of concept study. Anaesthesia 2020; 75:881-886. [DOI: 10.1111/anae.14945] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2019] [Indexed: 11/26/2022]
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11
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The Case for Bougie Use on Every Intubation. Air Med J 2019; 39:18-19. [PMID: 32044063 DOI: 10.1016/j.amj.2019.09.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 09/05/2019] [Accepted: 09/26/2019] [Indexed: 11/20/2022]
Abstract
Despite its value in emergency airway management, the endotracheal tube introducer, commonly known as the bougie, has traditionally been a point of disagreement between providers. It is typically viewed as a "rescue" device and not a primary airway tool. However, its value as a primary device during plan A has recently been recognized. Two studies have shown increased first-pass success using a bougie on the initial attempt. Additionally, bougie use on every intubation increases provider comfort with the device so that, on a truly difficult intubation, the skills and mechanics are instilled. In the out-of-hospital and critical care transport settings, intubation is often inherently more difficult because of varying environments. For these reasons, the bougie should be integrated into the first intubation attempt in emergent intubation.
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12
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Powell EK, Hinckley WR, Stolz U, Golden AJ, Ventura A, McMullan JT. Predictors of Definitive Airway Sans Hypoxia/Hypotension on First Attempt (DASH-1A) Success in Traumatically Injured Patients Undergoing Prehospital Intubation. PREHOSP EMERG CARE 2019; 24:470-477. [DOI: 10.1080/10903127.2019.1670299] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Elizabeth K. Powell
- Received October 7, 2018 from Department of Anesthesiology, University of Cincinnati, Cincinnati, Ohio (EKP); Department of Emergency Medicine, University of Cincinnati, Cincinnati,Ohio (WRH, US, AJG, AV, JTM). Revision received September 9, 2019; accepted for publication September 17, 2019
| | - William R. Hinckley
- Received October 7, 2018 from Department of Anesthesiology, University of Cincinnati, Cincinnati, Ohio (EKP); Department of Emergency Medicine, University of Cincinnati, Cincinnati,Ohio (WRH, US, AJG, AV, JTM). Revision received September 9, 2019; accepted for publication September 17, 2019
| | - Uwe Stolz
- Received October 7, 2018 from Department of Anesthesiology, University of Cincinnati, Cincinnati, Ohio (EKP); Department of Emergency Medicine, University of Cincinnati, Cincinnati,Ohio (WRH, US, AJG, AV, JTM). Revision received September 9, 2019; accepted for publication September 17, 2019
| | - Andrew J. Golden
- Received October 7, 2018 from Department of Anesthesiology, University of Cincinnati, Cincinnati, Ohio (EKP); Department of Emergency Medicine, University of Cincinnati, Cincinnati,Ohio (WRH, US, AJG, AV, JTM). Revision received September 9, 2019; accepted for publication September 17, 2019
| | - Amanda Ventura
- Received October 7, 2018 from Department of Anesthesiology, University of Cincinnati, Cincinnati, Ohio (EKP); Department of Emergency Medicine, University of Cincinnati, Cincinnati,Ohio (WRH, US, AJG, AV, JTM). Revision received September 9, 2019; accepted for publication September 17, 2019
| | - Jason T. McMullan
- Received October 7, 2018 from Department of Anesthesiology, University of Cincinnati, Cincinnati, Ohio (EKP); Department of Emergency Medicine, University of Cincinnati, Cincinnati,Ohio (WRH, US, AJG, AV, JTM). Revision received September 9, 2019; accepted for publication September 17, 2019
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13
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Wang X, Tao Y, Tao X, Chen J, Jin Y, Shan Z, Tan J, Cao Q, Pan T. An original design of remote robot-assisted intubation system. Sci Rep 2018; 8:13403. [PMID: 30194353 PMCID: PMC6128927 DOI: 10.1038/s41598-018-31607-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 08/22/2018] [Indexed: 12/03/2022] Open
Abstract
The success rate of pre-hospital endotracheal intubation (ETI) by paramedics is lower than physicians. We aimed to establish a remote robot-assisted intubation system (RRAIS) and expected it to improve success rate of pre-hospital ETI. To test the robot’s feasibility, 20 pigs were intubated by direct laryngoscope or the robot system. Intubation time, success rate, airway complications were recorded during the experiment. The animal experiment showed that participants achieved a higher success rate in absolute numbers by the robot system. In summary, we have successfully developed a remote robot-assisted intubation system. It is promising for RRAIS to improve the success rate of pre-hospital ETI and change the current rescue model.
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Affiliation(s)
- Xinyu Wang
- Department of Thoracic Surgery, Eastern Hepatobiliary Surgery Hospital affiliated to Second Military Medical University, Shanghai, China
| | - Yuanfa Tao
- Hefei University of Technology, Hefei, Anhui, China
| | - Xiandong Tao
- Department of Thoracic Surgery, Eastern Hepatobiliary Surgery Hospital affiliated to Second Military Medical University, Shanghai, China
| | - Jianglong Chen
- The Graduate School of Fujian Medical University, Fuzhou, Fujian, China
| | - Yifeng Jin
- Department of Thoracic Surgery, Eastern Hepatobiliary Surgery Hospital affiliated to Second Military Medical University, Shanghai, China
| | - Zhengxiang Shan
- Department of Thoracic Surgery, Eastern Hepatobiliary Surgery Hospital affiliated to Second Military Medical University, Shanghai, China
| | - Jiyang Tan
- Department of Orthopedics, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China
| | - Qixin Cao
- Shanghai Jiaotong University, Shanghai, China
| | - Tiewen Pan
- Department of Thoracic Surgery, Eastern Hepatobiliary Surgery Hospital affiliated to Second Military Medical University, Shanghai, China.
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