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Novices ventilate and intubate quicker and safer via intubating laryngeal mask than by conventional bag-mask ventilation and laryngoscopy.
Anesthesiology. 2007 Oct; 107(4):570-6.A

Abstract

BACKGROUND

Because airway management plays a key role in emergency medical care, methods other than laryngoscopic tracheal intubation (LG-TI) are being sought for inadequately experienced personnel. This study compares success rates for ventilation and intubation via the intubating laryngeal mask (ILMA-V/ILMA-TI) with those via bag-mask ventilation and laryngoscopic intubation (BM-V/LG-TI).

METHODS

In a prospective, randomized, crossover study, 30 final-year medical students, all with no experience in airway management, were requested to manage anesthetized patients who seemed normal on routine airway examination. Each participant was asked to intubate a total of six patients, three with each technique, in a randomly assigned order. A task not completed after two 60-s attempts was recorded as a failure, and the technique was switched.

RESULTS

The success rate with ILMA-V was significantly higher (97.8% vs. 85.6%; P < 0.05), and ventilation was established more rapidly with ILMA-V (35.6 +/- 8.0 vs. 44.3 +/- 10.8 s; P < 0.01). Intubation was successful more often with ILMA-TI (92.2% vs. 40.0%; P < 0.01). The time needed to achieve tracheal intubation was significantly shorter with ILMA-TI (45.7 +/- 14.8 vs. 89.1 +/- 23.3 s; P < 0.01). After failed LG-TI, ILMA-V was successful in all patients, and ILMA-TI was successful in 28 of 33 patients. Conversely, after failed ILMA-TI, BM-V was possible in all patients, and LG-TI was possible in 1 of 5 patients.

CONCLUSION

Medical students were more successful with ILMA-V/ILMA-TI than with BM-V/LG-TI. ILMA-TI can be successfully used when LG-TI has failed, but not vice versa. These results suggest that training programs should extend the ILMA to conventional airway management techniques for paramedical and medical personnel with little experience in airway management.

Authors+Show Affiliations

Department of Anesthesiology, Emergency and Intensive Care Medicine, Georg-August University, 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
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17893452

Citation

Timmermann, Arnd, et al. "Novices Ventilate and Intubate Quicker and Safer Via Intubating Laryngeal Mask Than By Conventional Bag-mask Ventilation and Laryngoscopy." Anesthesiology, vol. 107, no. 4, 2007, pp. 570-6.
Timmermann A, Russo SG, Crozier TA, et al. Novices ventilate and intubate quicker and safer via intubating laryngeal mask than by conventional bag-mask ventilation and laryngoscopy. Anesthesiology. 2007;107(4):570-6.
Timmermann, A., Russo, S. G., Crozier, T. A., Eich, C., Mundt, B., Albrecht, B., & Graf, B. M. (2007). Novices ventilate and intubate quicker and safer via intubating laryngeal mask than by conventional bag-mask ventilation and laryngoscopy. Anesthesiology, 107(4), 570-6.
Timmermann A, et al. Novices Ventilate and Intubate Quicker and Safer Via Intubating Laryngeal Mask Than By Conventional Bag-mask Ventilation and Laryngoscopy. Anesthesiology. 2007;107(4):570-6. PubMed PMID: 17893452.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Novices ventilate and intubate quicker and safer via intubating laryngeal mask than by conventional bag-mask ventilation and laryngoscopy. AU - Timmermann,Arnd, AU - Russo,Sebastian G, AU - Crozier,Thomas A, AU - Eich,Christoph, AU - Mundt,Birgit, AU - Albrecht,Bjoern, AU - Graf,Bernhard M, PY - 2007/9/26/pubmed PY - 2007/10/30/medline PY - 2007/9/26/entrez SP - 570 EP - 6 JF - Anesthesiology JO - Anesthesiology VL - 107 IS - 4 N2 - BACKGROUND: Because airway management plays a key role in emergency medical care, methods other than laryngoscopic tracheal intubation (LG-TI) are being sought for inadequately experienced personnel. This study compares success rates for ventilation and intubation via the intubating laryngeal mask (ILMA-V/ILMA-TI) with those via bag-mask ventilation and laryngoscopic intubation (BM-V/LG-TI). METHODS: In a prospective, randomized, crossover study, 30 final-year medical students, all with no experience in airway management, were requested to manage anesthetized patients who seemed normal on routine airway examination. Each participant was asked to intubate a total of six patients, three with each technique, in a randomly assigned order. A task not completed after two 60-s attempts was recorded as a failure, and the technique was switched. RESULTS: The success rate with ILMA-V was significantly higher (97.8% vs. 85.6%; P < 0.05), and ventilation was established more rapidly with ILMA-V (35.6 +/- 8.0 vs. 44.3 +/- 10.8 s; P < 0.01). Intubation was successful more often with ILMA-TI (92.2% vs. 40.0%; P < 0.01). The time needed to achieve tracheal intubation was significantly shorter with ILMA-TI (45.7 +/- 14.8 vs. 89.1 +/- 23.3 s; P < 0.01). After failed LG-TI, ILMA-V was successful in all patients, and ILMA-TI was successful in 28 of 33 patients. Conversely, after failed ILMA-TI, BM-V was possible in all patients, and LG-TI was possible in 1 of 5 patients. CONCLUSION: Medical students were more successful with ILMA-V/ILMA-TI than with BM-V/LG-TI. ILMA-TI can be successfully used when LG-TI has failed, but not vice versa. These results suggest that training programs should extend the ILMA to conventional airway management techniques for paramedical and medical personnel with little experience in airway management. SN - 0003-3022 UR - https://www.unboundmedicine.com/medline/citation/17893452/Novices_ventilate_and_intubate_quicker_and_safer_via_intubating_laryngeal_mask_than_by_conventional_bag_mask_ventilation_and_laryngoscopy_ L2 - https://pubs.asahq.org/anesthesiology/article-lookup/doi/10.1097/01.anes.0000281940.92807.23 DB - PRIME DP - Unbound Medicine ER -