A Comparison of Paramedic First Pass Endotracheal Intubation Success Rate of the VividTrac VT-A 100, GlideScope Ranger, and Direct Laryngoscopy Under Simulated Prehospital Cervical Spinal Immobilization Conditions in a Cadaveric Model

2017 ◽  
Vol 32 (6) ◽  
pp. 621-624 ◽  
Author(s):  
Ryan Hodnick ◽  
Tony Zitek ◽  
Kellen Galster ◽  
Stephen Johnson ◽  
Bryan Bledsoe ◽  
...  
Keyword(s):  
Success Rate ◽  
Endotracheal Intubation ◽  
Direct Laryngoscopy ◽  
Intubation Attempt ◽  
Spinal Immobilization ◽  
Significant Difference ◽  
Intubation Success ◽  
First Pass ◽  
Intubation Success Rate ◽  
Cadaveric Model

AbstractObjectiveThe primary goal of this study was to compare paramedic first pass success rate between two different video laryngoscopes and direct laryngoscopy (DL) under simulated prehospital conditions in a cadaveric model.MethodsThis was a non-randomized, group-controlled trial in which five non-embalmed, non-frozen cadavers were intubated under prehospital spinal immobilization conditions using DL and with both the GlideScope Ranger (GL; Verathon Inc, Bothell, Washington USA) and the VividTrac VT-A100 (VT; Vivid Medical, Palo Alto, California USA). Participants had to intubate each cadaver with each of the three devices (DL, GL, or VT) in a randomly assigned order. Paramedics were given 31 seconds for an intubation attempt and a maximum of three attempts per device to successfully intubate each cadaver. Confirmation of successful endotracheal intubation (ETI) was confirmed by one of the six on-site physicians.ResultsSuccessful ETI within three attempts across all devices occurred 99.5% of the time overall and individually 98.5% of the time for VT, 100.0% of the time for GL, and 100.0% of the time for DL. First pass success overall was 64.4%. Individually, first pass success was 60.0% for VT, 68.8% for GL, and 64.5% for DL. A chi-square test revealed no statistically significant difference amongst the three devices for first pass success rates (P=.583). Average time to successful intubation was 42.2 seconds for VT, 38.0 seconds for GL, and 33.7 for seconds for DL. The average number of intubation attempts for each device were as follows: 1.48 for VT, 1.40 for GL, and 1.42 for DL.ConclusionThe was no statistically significant difference in first pass or overall successful ETI rates between DL and video laryngoscopy (VL) with either the GL or VT (adult).HodnickR, ZitekT, GalsterK, JohnsonS, BledsoeB, EbbsD. A comparison of paramedic first pass endotracheal intubation success rate of the VividTrac VT-A 100, GlideScope Ranger, and direct laryngoscopy under simulated prehospital cervical spinal immobilization conditions in a cadaveric model. Prehosp Disaster Med. 2017;32(6):621–624.

scholarly journals Comparison of Direct and Indirect Laryngoscopes in Vomitus and Hematemesis Settings: A Randomized Simulation Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Ryosuke Mihara ◽  
Nobuyasu Komasawa ◽  
Sayuri Matsunami ◽  
Toshiaki Minami
Keyword(s):  
Tracheal Intubation ◽  
Success Rate ◽  
Macintosh Laryngoscope ◽  
Intubation Time ◽  
Direct Laryngoscope ◽  
Mcgrath Mac ◽  
Significant Difference ◽  
Intubation Success ◽  
Intubation Success Rate

Background.Videolaryngoscopes may not be useful in the presence of hematemesis or vomitus. We compared the utility of the Macintosh laryngoscope (McL), which is a direct laryngoscope, with that of the Pentax-AWS Airwayscope (AWS) and McGRATH MAC (McGRATH), which are videolaryngoscopes, in simulated hematemesis and vomitus settings.Methods.Seventeen anesthesiologists with more than 1 year of experience performed tracheal intubation on an adult manikin using McL, AWS, and McGRATH under normal, hematemesis, and vomitus simulations.Results.In the normal setting, the intubation success rate was 100% for all three laryngoscopes. In the hematemesis settings, the intubation success rate differed significantly among the three laryngoscopes (P=0.021). In the vomitus settings, all participants succeeded in tracheal intubation with McL or McGRATH, while five failed in the AWS trial with significant difference (P=0.003). The intubation time did not significantly differ in normal settings, while it was significantly longer in the AWS trial compared to McL or McGRATH trial in the hematemesis or vomitus settings (P<0.001, compared to McL or McGRATH in both settings).Conclusion.The performance of McGRATH and McL can be superior to that of AWS for tracheal intubation in vomitus and hematemesis settings in adults.

scholarly journals Nasal Probe Tests Decreased the Procedure Time During Flexible Bronchoscopy: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Wenjun Zhu ◽  
Yuchen Zhang ◽  
Jingyu Shi ◽  
Xiaoqin Wang ◽  
Renjiao Li ◽  
...  
Keyword(s):  
Nasal Cavity ◽  
Success Rate ◽  
Controlled Trial ◽  
Flexible Bronchoscopy ◽  
Control Group ◽  
Randomized Controlled ◽  
Intubation Success ◽  
First Pass ◽  
Intubation Success Rate ◽  
Nasal Bleeding

Abstract Background: Nasal insertion is the preferred method in flexible bronchoscopy; however, the relatively narrow nasal cavity increases the difficulty of bronchoscope insertion. The aim of the study was to investigate the advantages of a prior nasal cavity probe during flexible bronchoscopy and to investigate whether this novel method could reduce the complications associated with flexible bronchoscopy.Methods: This prospective randomized controlled trial was conducted in a tertiary hospital between May 2020 and October 2020. Three hundred patients requiring diagnosis and treatment using flexible bronchoscopy were randomly allocated to three groups: a control group, a simple cotton bud detection group (CD group), and an adrenaline detection group (AD group). The outcomes were the time to pass the glottis, the first-pass intubation success rate, and postoperative complications, especially nasal bleeding.Results: In total, 189 men and 111 women were enrolled in the study, with a mean age of 55.69 ± 12.86 years. The operation time was longer in the control group (24 [14.25-45.75] s) than in the CD group (19.5 [12.25-32.75] s). Compared with that in the CD group, the first-pass intubation success rate was significantly lower in the control group (p<0.05). There was no difference in nasal bleeding between the control group and the CD group (p=0.506). Nasal bleeding after flexible bronchoscopy was more common in the CD group than in the AD group (p=0.005); however, there was no significant between-group difference in hemostatic use (p=0.245). Conclusions: Use of a prior nasal cavity probe during flexible bronchoscopy can significantly reduce the time to pass the nasal cavity, improve the first-pass intubation success rate, and reduce postoperative nasal bleeding. Nasal detection is recommended as a time-saving procedure for patients undergoing flexible bronchoscopy. Trial registration: ChiCTR2000032668, 6th May.2020.

Comparison of Video Laryngoscopy and Direct Laryngoscopy in the Success of Intubation Performed by Novice Personnel in Patients with Cervical Immobilization: A Manikin Study

2021 ◽  
Author(s):  
Özge Can ◽  
Sercan Yalcinli ◽  
Yusuf Ali Altunci
Keyword(s):  
Success Rate ◽  
Direct Laryngoscopy ◽  
Video Laryngoscope ◽  
Video Laryngoscopy ◽  
First Year ◽  
Success Rates ◽  
Significant Difference ◽  
Intubation Success ◽  
Cervical Immobilization ◽  
Second Year

Introduction: Pre-hospital intubation is a challenging but essential intervention. During intubation, it is difficult to identify vocal cords when using a cervical collar and trauma board. Therefore, the success rate of intubation by paramedics decreases in trauma patients. Video laryngoscopy increases intubation success rate and has been recommended for difficult airways in studies. Objective: In this study, we compared the intubation success rates when using a video laryngoscope and a direct laryngoscope in a manikin with simulated cervical immobilization.  Methods: In this cross-sectional study, the manikin’s neck collar and spine board created a complicated airway model with cervical immobilization. Inexperienced paramedic students tried intubation with both methods, and their trial periods were recorded. Students answered a question evaluating the convenience of the procedure for both methods after the trial. Results: In this study, 83 volunteers, who were first-year and second-year paramedics, participated; 32 (38.6%) of the volunteers were first-year students, while 51 (61.4%) were second-year students. All volunteers had previous intubation experience with direct laryngoscopy, but not with video laryngoscopy. There was a statistically significant difference in the first-attempt success rates of the procedure between the groups in favor of video laryngoscope (p=0.022). Note that there was no significant difference between the groups in terms of first attempt durations (p=0.337). Conclusion: Video laryngoscopy in airway management can increase the success rate of first-attempt intubation by inexperienced pre-hospital healthcare personnel.

scholarly journals Effect of Rocuronium vs Succinylcholine on Endotracheal Intubation Success Rate Among Patients Undergoing Out-of-Hospital Rapid Sequence Intubation

JAMA ◽  
2019 ◽  
Vol 322 (23) ◽  
pp. 2303 ◽  
Author(s):  
Bertrand Guihard ◽  
Charlotte Chollet-Xémard ◽  
Philippe Lakhnati ◽  
Benoit Vivien ◽  
Claire Broche ◽  
...  
Keyword(s):  
Success Rate ◽  
Endotracheal Intubation ◽  
Rapid Sequence Intubation ◽  
Rapid Sequence ◽  
Intubation Success ◽  
Intubation Success Rate

First-pass intubation success rate during rapid sequence induction of prehospital anaesthesia by physicians versus paramedics

2015 ◽  
Vol 22 (6) ◽  
pp. 391-394 ◽  
Author(s):  
Joost Peters ◽  
Bas van Wageningen ◽  
Ilze Hendriks ◽  
Ruud Eijk ◽  
Michael Edwards ◽  
...  
Keyword(s):  
Success Rate ◽  
Rapid Sequence Induction ◽  
Rapid Sequence ◽  
Intubation Success ◽  
First Pass ◽  
Intubation Success Rate ◽  
Sequence Induction

Endotracheal Intubation in Patients With COVID-19 By Emergency Physicians in The Tokyo Metropolitan Area

2021 ◽  
Author(s):  
Mitsuhito Soh ◽  
Toru Hifumi ◽  
Norio Otani ◽  
Momoyo Miyazaki ◽  
Kentaro Kobayashi ◽  
...  
Keyword(s):  
Success Rate ◽  
Endotracheal Intubation ◽  
Metropolitan Area ◽  
Patient Characteristics ◽  
Emergency Physicians ◽  
Related Factors ◽  
Tokyo Metropolitan ◽  
Tokyo Metropolitan Area ◽  
Intubation Success ◽  
Intubation Success Rate

Abstract Background: Patients with COVID-19 may require emergency tracheal intubation for mechanical ventilation by emergency physicians. However, the success rate, complications, operator safety, and issues around personal protective equipment (PPE) and barrier enclosure use are not known in this context.Methods: This was a retrospective study of data for adult patients with COVID-19 who underwent endotracheal intubation performed by emergency physicians at four hospitals in the Tokyo Metropolitan Area between January 2020 and September 2020. Patient characteristics, intubation-related factors, and intubation success and complications rates were obtained. Two analyses were then performed. In analysis 1, the intubation success rate in patients was compared among four groups using different types of PPE. In analysis 2, patients were compared by those intubated with or without barrier enclosure.Results: In total, 46 patients met the inclusion criteria, of whom 85% were successfully intubated at the first attempt, 27% experienced hypotension, and 27% experienced hypoxia. No muscle relaxants were used in 8.7% and the Macintosh blade was used in 37%. The four PPE types and the intubation confirmation methods varied considerably, but all met the WHO recommendations. A barrier enclosure device was used in 26%, with a success rate of approximately 80% irrespective of its use.Conclusions: The success rate at the first attempt of intubation was relatively high, albeit with a moderately high complication rate. All PPE types were safe, including when barrier enclosures were used. Success was not affected by using barrier enclosures.

scholarly journals Intubation Success through I-Gel® and Intubating Laryngeal Mask Airway® Using Flexible Silicone Tubes: A Randomised Noninferiority Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Latha Naik ◽  
Neerja Bhardwaj ◽  
Indu Mohini Sen ◽  
Rakesh V. Sondekoppam
Keyword(s):  
Success Rate ◽  
Successful Intubation ◽  
Improve Performance ◽  
Elective Surgical Procedures ◽  
Intubating Laryngeal Mask Airway ◽  
Intubation Success ◽  
First Pass ◽  
Registration Number ◽  
Intubation Success Rate ◽  
Secondary Outcomes

Introduction. The study aims to test whether flexible silicone tubes (FST) improve performance and provide similar intubation success through I-Gel as compared to ILMA. Our trial is registered in CTRI and the registration number is “CTRI/2016/06/006997.”Methods. One hundred and twenty ASA status I-II patients scheduled for elective surgical procedures needing tracheal intubation were randomised to endotracheal intubation using FST through either I-Gel or ILMA. In the ILMA group (n=60), intubation was attempted through ILMA using FST and, in the I-Gel group (n=60), FST was inserted through I-Gel airway.Results. Successful intubation was achieved in 36.67% (95% CI 24.48%–48.86%) on first attempt through I-Gel (n=22/60) compared to 68.33% (95% CI 56.56%–80.1%) in ILMA (n=41/60) (p=0.001). The overall intubation success rate was also lower with I-Gel group [58.3% (95% CI 45.82%–70.78%);n=35] compared to ILMA [90% (95% CI 82.41%–97.59%);n=54] (p<0.001). The number of attempts, ease of intubation, and time to intubation were longer with I-Gel compared to ILMA. There were no differences in the other secondary outcomes.Conclusion. The first pass success rate and overall success of FST through an I-Gel airway were inferior to those of ILMA.

PP23  Soiled airway tracheal intubation and the effectiveness of decontamination by north east paramedics: a randomised controlled manikin study. The satiated2 study

2020 ◽  
Vol 37 (10) ◽  
pp. e11.1-e11
Author(s):  
Graham McClelland ◽  
Richard Pilbery ◽  
Sarah Hepburn
Keyword(s):  
Controlled Trial ◽  
Research Question ◽  
Ambulance Service ◽  
Success Rates ◽  
North East ◽  
Significant Difference ◽  
Intubation Success ◽  
First Pass ◽  
Intubation Success Rate ◽  
Randomised Controlled

BackgroundVomiting and regurgitation are commonly encountered in out-of-hospital cardiac arrest, but traditional paramedic suctioning techniques may be insufficient to manage severely soiled airways.A technique called Suction Assisted Laryngoscopy and Airway Decontamination (SALAD) has been developed to help clinicians manage these difficult airways. The only UK SALAD study (SATIATED) reported improved paramedic first-pass intubation success rate. This study has now been replicated in a different ambulance service.The primary research question was: Does paramedic first-pass intubation rate in North East Ambulance Service improve following training in SALAD? The secondary research question was: Does training in SALAD affect the time taken to intubate by paramedics?MethodsA randomised controlled trial of SALAD was conducted using a modified airway manikin capable of vomiting to simulate a soiled airway. The intervention comprised SALAD training and the introduction of the DuCanto catheter for post-training attempts. Participants were randomised into two groups: A01A02B01 who made two pre-training intubation attempts and one post-training attempt, and A11B11B12, who made one pre-training and two post-training attempts. Data were collected on length of service, success rates, timings and techniques used.ResultsParamedics (n=102 participants, n=99 completed the study) were recruited between August and December 2019. First-pass intubation success rates on the second attempts (A02versus B11) were 86% and 96% respectively; a non-significant improvement of 10% (95% CI 1–21%, p=0.09). Both groups intubated faster on third attempts compared to first attempts. A01 to B01 mean improvement 5 (SD 14) seconds, A11 to B12 mean improvement 9 (SD 15) seconds. There was no significant difference in improvement between groups (mean difference -4 seconds, 95% CI -11–3 seconds, p=0.22).ConclusionsNorth East Ambulance Service paramedics demonstrated improved first-pass intubation success rates in a simulated soiled airway following SALAD training and improved time to intubation. This study supports the findings of the SATIATED study.

scholarly journals Comparison of fastrach LMA and ILMA methods for airway management

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Mustafa Ozgur Cırık ◽  
◽  
Ramazan Baldemir ◽  
Sema Avcı ◽  
Hayal Tezel ◽  
...  
Keyword(s):  
Airway Management ◽  
Endotracheal Intubation ◽  
Direct Laryngoscopy ◽  
Upper Airway ◽  
Demographic Parameters ◽  
Success Rates ◽  
Airway Complications ◽  
Group I ◽  
Significant Difference ◽  
Intubation Success

The aim of this study is to compare the hemodynamic responses, durations of intubation, intubation success rates and postoperative upper airway complications between the intubation performed with direct laryngoscopy and blind intubation performed with LMA-Fastrach application in normotensive patients. This present study was performed with the approval of ethical committee and in the surgery rooms between the date March 2010-August 2010. The study was performed on 80 patients aged between 18 and 60 and had American Anesthetists Assosiation (ASA) classification I-II. Endotracheal intubation was essential in their elective abdomen surgeries. The patients were divided into 2 groups as ILMA-Fastrach Group (Group I, n=40) and laryngoscopy group (Group L, n=40). 80 patients aged between 18 and 60. Of those, 54 (67.5%) were female and 26 (32.5%) were male. The age average of the patients was 46.3 ± 10.7. There was not a statistically significant difference between the demographic parameters of the patients. When compared to the onset value of SAP in Group I and Group L, a statistically significant difference was not detected in the groups in terms of SAP 1st minute and 5th minute values. When compared to the SAP onset value of the cases, the decrease in the 1st minute was statistically significant and when compared to the 1st minute value, the decrease in the 5th minute was not statistically significant. In the groups, a statistically significant difference was not observed in terms of DAP outset 1st and 5th minute values. When compared to the DAP onset value of the patients in Group L, the increase in the 1st minute was statistically significant. When compared to the 1st minute value, the decrease in the 5th minute was statistically significant. When compared to the onset value of MAP in Group L, the increase in the 1st minute was statistically significant. In terms of HR onset 1st and 5th minute values a statistically significant value was not detected. In conclusion, patients performed endotracheal intubation with LMA-Fastrach was more stabile than the ones intubated with direct laryngoscopy in terms of hemodynamics. Fewer complications were observed in LMA-Fastrach group and there was not any difference in terms of success rates.

scholarly journals Does seniority always correlate with simulated intubation performance? Comparing endotracheal intubation performance across medical students, residents, and physicians using a high-fidelity simulator

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257969
Author(s):  
Sze-Yuen Yau ◽  
Yu-Che Chang ◽  
Meng-Yu Wu ◽  
Shu-Chen Liao
Keyword(s):  
Medical Students ◽  
Success Rate ◽  
Endotracheal Intubation ◽  
Undergraduate Students ◽  
High Fidelity ◽  
Fine Grained ◽  
Traditional Training ◽  
Intubation Success ◽  
Intubation Success Rate ◽  
Attending Physicians

Background Endotracheal intubation is crucial in emergency medical care and anaesthesia. Our study employed a high-fidelity simulator to explore differences in intubation success rate and other skills between junior and senior physicians. Methods We examined the performance of 50 subjects, including undergraduate students (UGY), postgraduate trainees (PGY), residents (R), and attending physicians (VS). Each participant performed 12 intubations (i.e. 3 devices x 4 scenarios) on a high-fidelity simulator. Main outcome measures included success rate, time for intubation, force applied on incisor and tongue, and Cormack Lehane grades. Results There was no primary effect of seniority on any outcome measure except success rate and Cormack Lehane grades. However, VS demonstrated shorter duration than medical students using Glidescope and direct laryngoscopy, whereas VS and R applied significantly more force on the incisor in the normal airway and rigid neck scenario respectively. Discussion Seniority does not always correlate with skill perfection in detailed processes. Our study suggests that the use of video laryngoscopy enhances the intubation success rate and speed, but the benefit only accrues to senior learners, whereby they applied more force on the incisor at a single peak under difficult scenarios. These findings are discussed in terms of psychological and cognitive perspectives. Conclusion Speed and safety are essential for high quality critical medical procedures. A tool should be designed and implemented to educate junior physicians with an emphasis on practice and efficiency, which should also contribute to updating senior physicians’ knowledge and competence by providing instant feedback on their performance. This type of fine-grained feedback could serve as a complement to traditional training and provide a sustainable learning model for medical education.

Sign in / Sign up

Export Citation Format

Share Document