scholarly journals Comparison of Pentax-AWS Airwayscope and Glidescope for Infant Tracheal Intubation by Anesthesiologists during Cardiopulmonary Arrest Simulation: A Randomized Crossover Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Shunsuke Fujiwara ◽  
Nobuyasu Komasawa ◽  
Sayuri Matsunami ◽  
Daisuke Okada ◽  
Toshiaki Minami
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Tracheal Intubation ◽  
Endotracheal Intubation ◽  
Crossover Trial ◽  
Cardiopulmonary Arrest ◽  
Intubation Time ◽  
Chest Compressions ◽  
Analog Scale ◽  
Randomized Crossover Trial ◽  
Better Than

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.

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

2021 ◽  
Vol 10 (24) ◽  
pp. 5740
Author(s):  
Leszek Gadek ◽  
Lukasz Szarpak ◽  
Lars Konge ◽  
Marek Dabrowski ◽  
Dominika Telecka-Gadek ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Crossover Trial ◽  
Life Support ◽  
Protective Equipment ◽  
Intubation Time ◽  
Success Rates ◽  
Direct Laryngoscope ◽  
Randomized Crossover Trial ◽  
Intubation Success ◽  
First Pass

A safe way of securing the airway with an endotracheal tube is one of the priorities of an advanced cardiovascular life support algorithm for suspected or confirmed COVID-19 patients. The aim of this study was to compare intubation success rates (ISR) and intubation time (IT) of different laryngoscopes for simulated COVID-19 patients under cardiopulmonary resuscitation. The study was designed as a prospective, randomized, crossover trial. Fifty four active paramedics performed endotracheal intubation with a Macintosh direct laryngoscope (MAC) and McGrath videolaryngoscope (McGrath) with and without personal protective equipment (PPE). Without PPE, ISRs were 87% and 98% for MAC and McGrath, respectively (p = 0.32). ITs were 22.5 s (IQR: 19–26) and 19.5 s (IQR: 17–21) for MAC and McGrath, respectively (p = 0.005). With PPE, first-pass ISR were 30% and 89% with MAC and McGrath, respectively (p < 0.001). The overall success rates were 83% vs. 100% (p = 0.002). Median ITs were 34.0 s (IQR: 29.5–38.5) and 24.8 s (IQR: 21–29) for MAC and McGrath, respectively (p < 0.001). In conclusion, the McGrath videolaryngoscope appears to possess significant advantages over the Macintosh direct laryngoscope when used by paramedics in suspected or confirmed COVID-19 intubation scenarios.

scholarly journals Comparison of i-Gel as a Conduit for Intubation between under Fiberoptic Guidance and Blind Endotracheal Intubation during Cardiopulmonary Resuscitation: A Randomized Simulation Study

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Hyun Young Choi ◽  
Wonhee Kim ◽  
Yong Soo Jang ◽  
Gu Hyun Kang ◽  
Jae Guk Kim ◽  
...  
Keyword(s):  
Success Rate ◽  
Endotracheal Intubation ◽  
Macintosh Laryngoscope ◽  
Secondary Outcome ◽  
Intubation Time ◽  
Chest Compressions ◽  
Intubation Technique ◽  
Endotracheal Tubes ◽  
Significant Difference ◽  
Post Hoc

Purpose. This study aimed to compare intubation performances among i-gel blind intubation (IGI), i-gel bronchoscopic intubation (IBRI), and intubation using Macintosh laryngoscope (MCL) applying two kinds of endotracheal tube during chest compressions. We hypothesized that IGI using wire-reinforced silicone (WRS) tube could achieve endotracheal intubation most rapidly and successfully. Methods. In 23 emergency physicians, a prospective randomized crossover manikin study was conducted to examine the three intubation techniques using two kinds of endotracheal tubes. The primary outcome was the intubation time. The secondary outcome was the cumulative success rate for each intubation technique. A significant difference was considered when identifying p<0.05 between two devices or p<0.017 in post hoc analysis of the comparison among three devices. Results. The mean intubation time using IGI was shorter (p<0.017) than that of using IBRI and MCL in both endotracheal tubes (17.6 vs. 29.3 vs. 20.2 in conventional polyvinyl chloride (PVC) tube; 14.6 vs. 27.4 vs. 19.9 in WRS tube; sec). There were no significant (p<0.05) differences between PVC and WRS tubes for each intubation technique. The intubation time to reach 100% cumulative success rate was also shorter in IGI (p<0.017) than that in IBRI and MCL in both PVC and WRS tubes. Conclusions. IGI was an equally successful and faster technique compared with IBRI or MCL regardless of the use of PVC or WRS tube. IGI might be an appropriate technique for emergent intubation by experienced intubators during chest compressions.

Utilizing Video versus Direct Laryngoscopy to Intubate Simulated Newborns while Contained within the Incubator: A Randomized Crossover Study

2019 ◽  
Vol 37 (05) ◽  
pp. 519-524
Author(s):  
Yuri Ozawa ◽  
Shigehiro Takahashi ◽  
Humiko Miyahara ◽  
Kenichiro Hosoi ◽  
Mazumi Miura ◽  
...  
Keyword(s):  
Direct Laryngoscopy ◽  
Neonatal Intensive Care ◽  
Crossover Trial ◽  
Linear Models ◽  
Video Laryngoscopy ◽  
Neonatal Intensive Care Units ◽  
Intubation Time ◽  
Randomized Crossover Trial ◽  
Side Walls ◽  
Randomized Crossover Study

Abstract Objective The use of video laryngoscopy for intubating neonates in ergonomically challenging settings has not been studied well. We aimed to assess the usefulness of video laryngoscopy for experienced neonatologists to intubate neonatal manikins in incubators via side hand ports or head window. Study Design In this randomized crossover trial at three neonatal intensive care units in Japan, 27 neonatologists were randomized into two groups, namely, those intubating neonatal simulators using video laryngoscopy and then using direct laryngoscopy, or vice versa. The intubations were performed via hand ports or head window without opening top and side walls in incubators in two manikin positions (rotated 90° or unrotated). Glottis visualization (0–100%), success rate, intubation time, and ease of laryngoscopy (from 1 [very difficult] to 10 [very easy]) were compared between video laryngoscopy and direct laryngoscopy. Generalized linear models were used for the analyses. Results This study assessed 108 intubations performed by 27 neonatologists. The use of video laryngoscopy improved the glottis visualization by 14% (95% confidence interval, 7.4–20%; p < 0.01) and easiness scores of laryngoscopy by 0.8 (0.2–1.4; p < 0.01), but did not reduce the intubation time. Conclusion Video laryngoscopy is useful for experienced neonatologists for intubating neonatal manikins in incubators without opening the top or side walls.

scholarly journals Bystander fatigue and CPR quality by older bystanders: a randomized crossover trial comparing continuous chest compressions and 30:2 compressions to ventilations

CJEM ◽  
2016 ◽  
Vol 18 (6) ◽  
pp. 461-468 ◽  
Author(s):  
Shawn Liu ◽  
Christian Vaillancourt ◽  
Ann Kasaboski ◽  
Monica Taljaard
Keyword(s):  
Chest Compression ◽  
Crossover Trial ◽  
Tertiary Care ◽  
Rest Period ◽  
Mean Difference ◽  
Chest Compressions ◽  
Lay Persons ◽  
Randomized Crossover Trial ◽  
Cpr Quality ◽  
Cpr Training

ABSTRACTObjectivesThis study sought to measure bystander fatigue and cardiopulmonary resuscitation (CPR) quality after five minutes of CPR using the continuous chest compression (CCC) versus the 30:2 chest compression to ventilation method in older lay persons, a population most likely to perform CPR on cardiac arrest victims.MethodsThis randomized crossover trial took place at three tertiary care hospitals and a seniors’ center. Participants were aged ≥55 years without significant physical limitations (frailty score ≤3/7). They completed two 5-minute CPR sessions (using 30:2 and CCC) on manikins; sessions were separated by a rest period. We used concealed block randomization to determine CPR method order. Metronome feedback maintained a compression rate of 100/minute. We measured heart rate (HR), mean arterial pressure (MAP), and Borg Exertion Scale. CPR quality measures included total number of compressions and number of adequate compressions (depth ≥5 cm).ResultsSixty-three participants were enrolled: mean age 70.8 years, female 66.7%, past CPR training 60.3%. Bystander fatigue was similar between CPR methods: mean difference in HR -0.59 (95% CI −3.51-2.33), MAP 1.64 (95% CI −0.23-3.50), and Borg 0.46 (95% CI 0.07-0.84). Compared to 30:2, participants using CCC performed more chest compressions (480.0 v. 376.3, mean difference 107.7; p<0.0001) and more adequate chest compressions (381.5 v. 324.9, mean difference. 62.0; p=0.0001), although good compressions/minute declined significantly faster with the CCC method (p=0.0002).ConclusionsCPR quality decreased significantly faster when performing CCC compared to 30:2. However, performing CCC produced more adequate compressions overall with a similar level of fatigue compared to the 30:2 method.

Impact of chest compression on endotracheal intubation efficacy: a randomized crossover trial

2018 ◽  
Vol 31 (1) ◽  
Author(s):  
Lukasz Szarpak ◽  
Agnieszka Madziala ◽  
Marek Dabrowski ◽  
Halla Kaminska ◽  
Wojciech Wieczorek ◽  
...  
Keyword(s):  
Endotracheal Intubation ◽  
Chest Compression ◽  
Crossover Trial ◽  
Randomized Crossover Trial
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