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Laryngoscopic versus intubating LMA guided tracheal intubation by novice users--a manikin study.
Resuscitation. 2007 Jun; 73(3):412-6.R

Abstract

AIM OF THE STUDY

Airway control is a potentially lifesaving procedure but tracheal intubation by direct laryngoscopy is difficult. This pilot study was conducted to determine whether tracheal intubation was more rapid and the success rate higher using an intubating laryngeal mask airway.

MATERIAL AND METHODS

The success rates of 119 medical students without prior airway management experience in ventilating and then intubating the trachea of a Laerdal Airway Management Trainer with two different methods were compared. The methods were bag-mask ventilation (BM-V) followed by laryngoscopic intubation (LG-TI), and intubating laryngeal mask ventilation (ILMA-V) followed by ILMA-guided tracheal intubation (ILMA-TI). After an introductory lecture and demonstration, each student was allowed three attempts to intubate using each method in random order.

RESULTS

All participants were successful with BM-V and ILMA-V on the first attempt. Laryngoscopic tracheal intubation was achieved by 60 (50.4%), 31 (26.1%) and 12 (10.1%) participants on the first, second and third attempt, respectively, while 16 (13.4%) failed in all three attempts. In the ILMA-TI group, 107 (90.0%), 10 (8.4%) and 2 (1.6%) succeeded on the first, second and third attempt, respectively. None failed. The intergroup difference is highly significant (p<0.001). Male participants were more successful with LG-TI than female (p<0.01), but not with ILMA-TI.

CONCLUSION

Laryngoscopic orotracheal intubation is difficult for the untrained, but all participants were successful with ILMA-TI. These data suggest that alternative devices such as the ILMA should be included in the medical school curriculum for airway management.

Authors+Show Affiliations

Department of Anaesthesiology, Emergency and Intensive Care Medicine, Georg-August University, Robert-Koch-Strasse 40, 37075 Goettingen, Germany. atimmer@zari.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17343972

Citation

Timmermann, A, et al. "Laryngoscopic Versus Intubating LMA Guided Tracheal Intubation By Novice Users--a Manikin Study." Resuscitation, vol. 73, no. 3, 2007, pp. 412-6.
Timmermann A, Russo SG, Crozier TA, et al. Laryngoscopic versus intubating LMA guided tracheal intubation by novice users--a manikin study. Resuscitation. 2007;73(3):412-6.
Timmermann, A., Russo, S. G., Crozier, T. A., Nickel, E. A., Kazmaier, S., Eich, C., & Graf, B. M. (2007). Laryngoscopic versus intubating LMA guided tracheal intubation by novice users--a manikin study. Resuscitation, 73(3), 412-6.
Timmermann A, et al. Laryngoscopic Versus Intubating LMA Guided Tracheal Intubation By Novice Users--a Manikin Study. Resuscitation. 2007;73(3):412-6. PubMed PMID: 17343972.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laryngoscopic versus intubating LMA guided tracheal intubation by novice users--a manikin study. AU - Timmermann,A, AU - Russo,S G, AU - Crozier,T A, AU - Nickel,E A, AU - Kazmaier,S, AU - Eich,C, AU - Graf,B M, Y1 - 2007/03/06/ PY - 2006/09/11/received PY - 2006/10/17/revised PY - 2006/10/27/accepted PY - 2007/3/9/pubmed PY - 2007/8/19/medline PY - 2007/3/9/entrez SP - 412 EP - 6 JF - Resuscitation JO - Resuscitation VL - 73 IS - 3 N2 - AIM OF THE STUDY: Airway control is a potentially lifesaving procedure but tracheal intubation by direct laryngoscopy is difficult. This pilot study was conducted to determine whether tracheal intubation was more rapid and the success rate higher using an intubating laryngeal mask airway. MATERIAL AND METHODS: The success rates of 119 medical students without prior airway management experience in ventilating and then intubating the trachea of a Laerdal Airway Management Trainer with two different methods were compared. The methods were bag-mask ventilation (BM-V) followed by laryngoscopic intubation (LG-TI), and intubating laryngeal mask ventilation (ILMA-V) followed by ILMA-guided tracheal intubation (ILMA-TI). After an introductory lecture and demonstration, each student was allowed three attempts to intubate using each method in random order. RESULTS: All participants were successful with BM-V and ILMA-V on the first attempt. Laryngoscopic tracheal intubation was achieved by 60 (50.4%), 31 (26.1%) and 12 (10.1%) participants on the first, second and third attempt, respectively, while 16 (13.4%) failed in all three attempts. In the ILMA-TI group, 107 (90.0%), 10 (8.4%) and 2 (1.6%) succeeded on the first, second and third attempt, respectively. None failed. The intergroup difference is highly significant (p<0.001). Male participants were more successful with LG-TI than female (p<0.01), but not with ILMA-TI. CONCLUSION: Laryngoscopic orotracheal intubation is difficult for the untrained, but all participants were successful with ILMA-TI. These data suggest that alternative devices such as the ILMA should be included in the medical school curriculum for airway management. SN - 0300-9572 UR - https://www.unboundmedicine.com/medline/citation/17343972/Laryngoscopic_versus_intubating_LMA_guided_tracheal_intubation_by_novice_users__a_manikin_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0300-9572(06)00720-9 DB - PRIME DP - Unbound Medicine ER -