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Feasibility of flexible lightwand-guided tracheal intubation with the intubating laryngeal mask during out-of-hospital cardiopulmonary resuscitation by an emergency physician.
Eur J Anaesthesiol. 2006 Jan; 23(1):76-9.EJ

Abstract

BACKGROUND AND OBJECTIVE

We tested the feasibility of using the intubating laryngeal mask airway Fastrach (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.

Authors+Show Affiliations

General Hospital of Athens, Greece.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16390571

Citation

Dimitriou, V, et al. "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, vol. 23, no. 1, 2006, pp. 76-9.
Dimitriou V, Voyagis GS, Grosomanidis V, et al. Feasibility of flexible lightwand-guided tracheal intubation with the intubating laryngeal mask during out-of-hospital cardiopulmonary resuscitation by an emergency physician. Eur J Anaesthesiol. 2006;23(1):76-9.
Dimitriou, V., Voyagis, G. S., Grosomanidis, V., & 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), 76-9.
Dimitriou V, et al. Feasibility of Flexible Lightwand-guided Tracheal Intubation With the Intubating Laryngeal Mask During Out-of-hospital Cardiopulmonary Resuscitation By an Emergency Physician. Eur J Anaesthesiol. 2006;23(1):76-9. PubMed PMID: 16390571.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Feasibility of flexible lightwand-guided tracheal intubation with the intubating laryngeal mask during out-of-hospital cardiopulmonary resuscitation by an emergency physician. AU - Dimitriou,V, AU - Voyagis,G S, AU - Grosomanidis,V, AU - Brimacombe,J, PY - 2005/08/18/accepted PY - 2006/1/5/pubmed PY - 2006/4/21/medline PY - 2006/1/5/entrez SP - 76 EP - 9 JF - European journal of anaesthesiology JO - Eur J Anaesthesiol VL - 23 IS - 1 N2 - BACKGROUND AND OBJECTIVE: We tested the feasibility of using the intubating laryngeal mask airway Fastrach (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. SN - 0265-0215 UR - https://www.unboundmedicine.com/medline/citation/16390571/Feasibility_of_flexible_lightwand_guided_tracheal_intubation_with_the_intubating_laryngeal_mask_during_out_of_hospital_cardiopulmonary_resuscitation_by_an_emergency_physician_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=16390571.ui DB - PRIME DP - Unbound Medicine ER -