In a difficult access scenario, supraglottic airway devices improve success and time to ventilation. (October 2015)

• Record Type: Journal Article
• Authors: Wetsch, Wolfgang A.; Schneider, Andreas; Schier, Robert; Spelten, Oliver; Hellmich, Martin; Hinkelbein, Jochen
• Is Part Of: European journal of emergency medicine. Volume 22:Number 5(2015)
• Publication Date: 2015-10
• Subjects: Emergency medicine -- Europe -- Periodicals; Medical emergencies -- Europe -- Periodicals; Emergency medical services -- Europe -- Periodicals; Emergencies -- Europe -- Periodicals; Emergency Medical Services -- Europe -- Periodicals; Emergency Medicine -- Europe -- periodicals; 616.025
• DOI: 10.1097/MEJ.0000000000000230
• Languages: English
• ISSNs: 0969-9546

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <p>The success of tracheal intubation (TI) is unacceptably low in unconventional positions. Supraglottic airway devices (SAD) have become an important alternative. An airway manikin was placed in a car, simulating an entrapped motor vehicle accident victim. The rescuer only had access through the driver's door. Participants were (<italic>n</italic>=25) anaesthesiologists with experience in prehospital emergency medicine. They attempted to secure the airway by TI or an SAD (Ambu AuraOnce, iGel, laryngeal tube) in a random sequence. Performance was compared using the Wilcoxon signed-rank test. <italic>P</italic> values less than 0.05 were considered statistically significant. Fastest effective ventilation was achieved with iGel (11.5±6.9 s, <italic>P</italic>&lt;0.001), followed by a laryngeal mask (15.1±5.6 s, <italic>P</italic>&lt;0.001) and a laryngeal tube (17.6±5.3 s, <italic>P</italic>&lt;0.001); TI was the slowest (42.8±23.9 s, comparator). iGel (<italic>P</italic>&lt;0.001) and laryngeal mask (<italic>P</italic>=0.01) also significantly outperformed the laryngeal tube. First ventilation was achieved significantly faster with SADs compared with TI. Success rates were also higher when using SADs.</p> </sec> </abstract>