Feasibility of flexible lightwand-guided tracheal intubation with the intubating laryngeal mask during out-of-hospital cardiopulmonary resuscitation by an emergency physician

Dimitriou, V., Voyagis, G.S., Grosomanidis, V., and Brimacombe, J. (2006) Feasibility of flexible lightwand-guided tracheal intubation with the intubating laryngeal mask during out-of-hospital cardiopulmonary resuscitation by an emergency physician. European Journal of Anaesthesiology, 23 (1). pp. 76-79.

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Abstract

Background and objective: We tested the feasibility of using the intubating laryngeal mask airway Fastrach(TM) (ILMA) as a ventilatory device and for flexible lightwand-guided tracheal intubation for out-of-hospital cardiopulmonary resuscitation by an emergency physician.

Methods: After completion of a training programme, a single experienced emergency physician used the technique for all patients requiring out-of-hospital tracheal intubation over a 10-month period. If access to the head and neck was limited, the intubating laryngeal mask airway was inserted from below and to the side, otherwise it was inserted from above the head. Data about the time for the ambulance to reach the patient, whether or not access to the head and neck was limited, whether or not circulation was successfully restored, and the insertion and intubation success rates were noted.

Results: The mean (range) time for the ambulance to reach the patient was 12 (10-20) min. Access to the head and neck was limited in 8/37 (22%). Circulation was successfully restored in 10/37 (27%). The intubating laryngeal mask airway was successfully inserted at the first attempt in 35/37 (95%) and at the second attempt in 2/37 (5%). The tracheal tube was successfully inserted in 25/37 (67.5%) at the first attempt, 7/37 (19%) at the second attempt and 5/37 (13.5%) at the third attempt. There were no overall failures for intubating laryngeal mask airway insertion or tracheal intubation. There were no differences in success rate between positions. Oesophageal intubation was detected and corrected in 2/37 (5%).

Conclusion: The intubating laryngeal mask airway has a high success rate as a ventilatory device and as a flexible lightwand-guided airway intubator during out-of-hospital cardiopulmonary resuscitation by a well-trained emergency physician. This technique may be particularly useful when there is limited access to the head and neck.

Item ID: 3763
Item Type: Article (Refereed Research - C1)
Keywords: laryngeal maks; ventilation artificial; intubation intratracheal; cardiopulmonary resuscitation
ISSN: 1365-2346
Date Deposited: 26 Nov 2009 03:12
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1102 Cardiovascular Medicine and Haematology > 110201 Cardiology (incl Cardiovascular Diseases) @ 50%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110301 Anaesthesiology @ 50%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920118 Surgical Methods and Procedures @ 100%
Citation Count from Web of Science Web of Science 15
Downloads: Total: 1
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