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Wieczorek P, Pruc M, Krajsman MJ, Wieczorek W, Cander B, Szarpak L, Navolokina A, Matuszewski M, Zyla M, Bragazzi NL, Smereka J. A randomized crossover comparison of the bébé VieScope and direct laryngoscope for pediatric airway management by nurses in medical simulation settings. Expert Rev Med Devices 2023; 20:943-950. [PMID: 37668350 DOI: 10.1080/17434440.2023.2253142] [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: 04/09/2023] [Revised: 08/23/2023] [Accepted: 08/25/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Airway management in life-threatening emergencies is essential for children, and endotracheal intubation is the gold standard. It protects against regurgitation and enables mechanical ventilation. New types of airway management equipment are being developed and implemented to meet the needs of medical personnel. RESEARCH DESIGN AND METHODS This prospective, randomized, cross-over simulation trial evaluated the success of endotracheal intubation in three scenarios: normal airway (scenario-A), tongue edema (scenario-B), and continuous chest compression (scenario-C), using the bébé Vie Scope™ laryngoscope (VieScope) and the Macintosh blade laryngoscope (MAC) as a comparative tool performed by nurses with limited tracheal intubation experience. RESULTS The results of the study showed that in scenario-A, there were no significant differences in the first attempt success rate or endotracheal intubation time between VieScope and MAC. However, VieScope was associated with better visualization of the glottis. In scenarios B and C, VieScope was significantly more effective than MAC in terms of first-pass success rate, time to intubate, Cormack-Lehane grade, POGO score, and ease of endotracheal intubation. CONCLUSIONS Bébé VieScope may be useful for endotracheal intubation in pediatric patients, particularly in cases of tongue edema and ongoing chest compression, providing a higher first-pass success rate than conventional laryngoscopes.
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Affiliation(s)
- Pawel Wieczorek
- Pediatric Intensive Care Unit (PICU), John Paul II Upper Silesian Health Centre in Katowice, Katowice, Poland
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
| | - Michal Pruc
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
| | - Maciej J Krajsman
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, Warsaw, Poland
| | - Wojciech Wieczorek
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
- Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Basar Cander
- Department of Emergency Medicine, Bezmialem Vakif University, Fatih/Istanbul, Turkey
| | - Lukasz Szarpak
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine Houston, Houston, TX, USA
- Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
| | - Alla Navolokina
- European School of Medicine, International European University, Kyiv, Ukraine
| | - Michal Matuszewski
- Department of Anaesthesiology and Intensive Therapy The Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland
| | - Michal Zyla
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
| | - Nicola L Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, UK
| | - Jacek Smereka
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
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Blind intubation in COVID-19 patients airway management. Am J Emerg Med 2021; 56:386. [PMID: 34840002 PMCID: PMC8607747 DOI: 10.1016/j.ajem.2021.11.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 11/19/2021] [Indexed: 11/23/2022] Open
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Ruetzler K, Madziala A, Madziala M, Pruc M, Dunder D. Attitudes of firefighters towards the use of supraglottic airways devices. Am J Emerg Med 2019; 37:1392-1393. [PMID: 30674429 DOI: 10.1016/j.ajem.2019.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 01/16/2019] [Indexed: 10/27/2022] Open
Affiliation(s)
- Kurt Ruetzler
- Department of General Anesthesiology, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Outcome Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA
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Ambu® AuraGain™ laryngeal mask as a method of airway management of patient entrapped in vehicle. Am J Emerg Med 2019; 37:171-172. [DOI: 10.1016/j.ajem.2018.05.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 05/29/2018] [Indexed: 11/24/2022] Open
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Comparison of blind intubation with different supraglottic airway devices by inexperienced physicians in several airway scenarios: a manikin study. Eur J Pediatr 2019; 178:871-882. [PMID: 30903306 PMCID: PMC6511343 DOI: 10.1007/s00431-019-03345-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 02/09/2019] [Accepted: 02/12/2019] [Indexed: 10/31/2022]
Abstract
Endotracheal intubation is the gold standard for airway management. Supraglottic airway devices (SADs) are useful in airway abnormalities. SAD blind intubation enables airway management with better ventilation and a reduced risk of gastric content aspiration. The aim was to compare various SADs in blind intubation performed by inexperienced physicians in several pediatric airway scenarios. One hundred sixteen physicians with no previous experience with SAD performed blind endotracheal intubations with (1) iGEL, (2) Air-Q intubating laryngeal airway, and (3) Ambu AuraGain disposable laryngeal mask in a pediatric manikin in three airway scenarios: (A) normal airway without chest compressions, (B) normal airway with continuous chest compressions with the CORPULS CPR system, and (C) difficult airway with continuous chest compressions with the CORPULS CPR system. Intubation tube with 5.0 internal diameter was used for all blind intubation attempts. First intubation success rate, median time to SAD placement, time to endotracheal intubation with SAD, and ease to perform the intubation were investigated in this study. All these parameters were better or non-inferior for iGEL in all investigated scenarios.Conclusion: Our manikin study demonstrated that iGEL was the most effective device for blind intubation by inexperienced physicians in different pediatric airway scenarios. What is Known: • For pediatric resuscitation, bag-mask ventilation is the first-line method for airway control and ventilation. • Endotracheal intubation is considered by many scientific societies the gold standard for airway management. • Supraglottic airway devices are particularly useful when bag-mask ventilation is difficult or impossible but can be also used for blind intubation. What is New: • The iGEL laryngeal mask turns out the most effective device for blind intubation by inexperienced physicians in different pediatric airway scenarios. • It may be a reasonable first emergency blind intubation technique for inexperienced physicians in pediatric patients in normal airway with and without continuous chest compressions, as well as in difficult airway with continuous chest compressions.
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Bielski A, Rivas E, Ruetzler K, Smereka J, Puslecki M, Dabrowski M, Ladny JR, Frass M, Robak O, Evrin T, Szarpak L. Comparison of blind intubation via supraglottic airway devices versus standard intubation during different airway emergency scenarios in inexperienced hand: Randomized, crossover manikin trial. Medicine (Baltimore) 2018; 97:e12593. [PMID: 30290627 PMCID: PMC6200544 DOI: 10.1097/md.0000000000012593] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Securing the airway and enabling adequate oxygenation and ventilation is essential during cardiopulmonary resuscitation (CPR). The aim of the study was to evaluate the success rate of blind intubation via the I-Gel and the Air-Q compared with direct laryngoscopy guided endotracheal intubation by inexperienced physician and to measure time to successful intubation. METHODS The study was designed as a randomized, cross-over simulation study. A total of 134 physicians, from specialties other than Anesthesia or Emergency Medicine, who considered themselves skilled in endotracheal intubation but who have never used any kind of supraglottic airway device performed blind intubation via the I-Gel and Air-Q and direct laryngoscopy guided endotracheal intubation in 3 randomized scenarios: normal airway without chest compression during intubation attempt; normal airway with continuous chest compression during intubation attempt; difficult airway with continuous chest compression. RESULTS Scenario A: Success rate with initial intubation attempt was 72% for endotracheal intubation, 75% in Air-Q, and 81% in I-Gel. Time to endotracheal intubation and ease of intubation was comparable with all 3 airway devices used. Scenario B: Success rate with the initial intubation attempt was 42% for endotracheal intubation, compared with 75% in Air-Q and 80% in I-Gel. Time for endotracheal intubation was significantly prolonged in endotracheal intubation (42 seconds, 35-49), compared with Air-Q (21 seconds, 18-32) and I-Gel (19 seconds, 17-27). Scenario C: The success rate with the initial intubation attempt was 23% in endotracheal intubation, compared with 65% in Air-Q and 74% in I-Gel. Time to intubation was comparable with both supraglottic airway devices (20 vs 22 seconds) but was significantly shorter compared with endotracheal intubation (50 seconds, P < .001). CONCLUSIONS Less to moderately experienced providers are able to perform endotracheal intubation in easy airways but fail during ongoing chest compressions and simulated difficult airway. Consequently, less to moderately experienced providers should refrain from endotracheal intubation during ongoing chest compressions during CPR and in expected difficult airways. Supraglottic airway devices are reliable alternatives and blind intubation through these devices is a valuable airway management strategy.
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Affiliation(s)
| | - Eva Rivas
- Department of Anesthesiology, Hospital Clinic, IDIBAPS (Institut d’Investigacions Biomèdiques August Pi i Sunyer), University of Barcelona, Barcelona, Spain
- Department of OUTCOMES RESEARCH, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio
| | - Kurt Ruetzler
- Department of OUTCOMES RESEARCH, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw
| | - Mateusz Puslecki
- Department of Rescue Medical Service, Poznan University of Medical Sciences, Poznan
| | - Marek Dabrowski
- Department of Rescue Medical Service, Poznan University of Medical Sciences, Poznan
| | - Jerzy R. Ladny
- Department of Emergency Medicine and Disaster, Medical University Bialystok, Bialystok
| | - Michael Frass
- Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Oliver Robak
- Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Togay Evrin
- Department of Emergency Medicine, UFuK University Medical Faculty, Dr Ridvan Ege Education and Research Hospital, Ankara, Turkey
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Kaminska H, Wieczorek W, Dabrowski M, Nadolny K, Smereka J. Knowledge and attitudes of paramedics toward the usage of capnography as a ventilation monitoring tool during resuscitation. Am J Emerg Med 2018; 36:1116-1117. [DOI: 10.1016/j.ajem.2017.10.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 10/18/2017] [Indexed: 10/18/2022] Open
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Evrin T, Iskrzycki L, Gawlowski P. The usage of Ambu® AuraGain™ laryngeal mask airway by the lifeguards. Am J Emerg Med 2018; 36:2331-2332. [PMID: 29709401 DOI: 10.1016/j.ajem.2018.04.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 04/23/2018] [Indexed: 10/17/2022] Open
Affiliation(s)
- Togay Evrin
- Department of Emergency Medicine, UFuK University, Ankara, Turkey; Medical Faculty, Dr Ridvan Ege Education and Research Hospital, Ankara, Turkey
| | - Lukasz Iskrzycki
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland.
| | - Pawel Gawlowski
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
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Konski R, Cieciel M, Madziala M, Madziala A. Impact of a CPRMeter feedback device on chest compression quality performer by nurses: A randomized crossover study. Am J Emerg Med 2018; 36:2321-2322. [PMID: 29680358 DOI: 10.1016/j.ajem.2018.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 04/11/2018] [Indexed: 10/17/2022] Open
Affiliation(s)
- Roman Konski
- Emergency Medicine Student Scientific Circle at Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Michal Cieciel
- Emergency Medicine Student Scientific Circle at Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Marcin Madziala
- International Institute of Rescue Research and Education, Warsaw, Poland.; Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland.
| | - Agnieszka Madziala
- International Institute of Rescue Research and Education, Warsaw, Poland.; Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland
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Evrin T, Madziala M. iGEL vs laryngeal tube for airway management during a normal airway scenario. Am J Emerg Med 2018. [PMID: 29519762 DOI: 10.1016/j.ajem.2018.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
- Togay Evrin
- Department of Emergency Medicine, UFuK University Medical Faculty, Dr Ridvan Ege Education and Research Hospital, Ankara, Turkey
| | - Marcin Madziala
- International Institute of Rescue Research and Education, Warsaw, Poland; Department of Emergency Medicine, Medical University of Warsaw, Poland.
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Kaminska H, Gawel WB, Wieczorek W. Which option for ventilation is optimal for resuscitation performed by nurses? Pilot data. Am J Emerg Med 2018; 36:1710-1711. [PMID: 29395777 DOI: 10.1016/j.ajem.2018.01.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 01/23/2018] [Indexed: 11/25/2022] Open
Affiliation(s)
- Halla Kaminska
- Department of Children's Diabetology, Medical University of Silesia, Katowice, Poland
| | - Wladysław B Gawel
- Student's Scientific Association of Children's Diabetology of Medical University of Silesia, Poland
| | - Wojciech Wieczorek
- Department of Anaesthesiology, Intensive Care and Emergency Medicine in Zabrze, Medical University of Silesia, Katowice, Poland.
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Kaminska H, Wieczorek W, Dabrowski M, Smereka J, Szarpak L, Ladny JR. Comparison of four laryngoscopes in cervical immobilization scenario. Pilot data. Am J Emerg Med 2017; 36:890-891. [PMID: 28928000 DOI: 10.1016/j.ajem.2017.09.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 09/13/2017] [Accepted: 09/14/2017] [Indexed: 11/24/2022] Open
Affiliation(s)
- Halla Kaminska
- Department of Children's Diabetology, Medical University of Silesia, Katowice, Poland
| | - Wojciech Wieczorek
- Department of Anaesthesiology, Intensive Care and Emergency Medicine in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Marek Dabrowski
- Department of Rescue and Disaster Medicine, Poznan University of Medical Sciences, Poland
| | - Jacek Smereka
- Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Lukasz Szarpak
- Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland.
| | - Jerzy Robert Ladny
- Department of Emergency Medicine and Disaster, Medical University Bialystok, Bialystok, Poland
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Sierzantowicz R, Dabrowska A, Dabrowski M, Drozd A, Wojewodzka-Zelezniakowicz M. ETView® video-tube versus Intubrite® laryngoscope for endotracheal intubation during CPR. Am J Emerg Med 2017; 35:1367-1368. [PMID: 28274710 DOI: 10.1016/j.ajem.2017.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 03/01/2017] [Accepted: 03/02/2017] [Indexed: 10/20/2022] Open
Affiliation(s)
| | - Agata Dabrowska
- Department of Rescue and Disaster Medicine, Poznan University of Medical Sciences, Poland
| | - Marek Dabrowski
- Department of Rescue and Disaster Medicine, Poznan University of Medical Sciences, Poland
| | - Anna Drozd
- International Institute of Rescue Research and Education, Warsaw, Poland
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