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Intubation Success Rate (intubation + success_rate)

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Medical Sciences	100%

Selected Abstracts

The Usefulness of Design of Experimentation in Defining the Effect Difficult Airway Factors and Training Have on Simulator Oral,Tracheal Intubation Success Rates in Novice Intubators

ACADEMIC EMERGENCY MEDICINE, Issue 4 2010
Frank Thomas MD
Abstract Objectives:, This exploratory study examined novice intubators and the effect difficult airway factors have on pre- and posttraining oral,tracheal simulation intubation success rates. Methods:, Using a two-level, full-factorial design of experimentation (DOE) involving a combination of six airway factors (curved vs. straight laryngoscope blade, trismus, tongue edema, laryngeal spasm, pharyngeal obstruction, or cervical immobilization), 64 airway scenarios were prospectively randomized to 12 critical care nurses to evaluate pre- and posttraining first-pass intubation success rates on a simulator. Scenario variables and intubation outcomes were analyzed using a generalized linear mixed-effects model to determine two-way main and interactive effects. Results:, Interactive effects between the six study factors were nonsignificant (p = 0.69). For both pre- and posttraining, main effects showed the straight blade (p = 0.006), tongue edema (p = 0.0001), and laryngeal spasm (p = 0.004) significantly reduced success rates, while trismus (p = 0.358), pharyngeal obstruction (p = 0.078), and cervical immobilization did not significantly change the success rate. First-pass intubation success rate on the simulator significantly improved (p = 0.005) from pre- (19%) to posttraining (36%). Conclusions:, Design of experimentation is useful in analyzing the effect difficult airway factors and training have on simulator intubation success rates. Future quality improvement DOE simulator research studies should be performed to help clarify the relationship between simulator factors and patient intubation rates. ACADEMIC EMERGENCY MEDICINE 2010; 17:460,463 © 2010 by the Society for Academic Emergency Medicine [source]

Human Patient Simulation Is Effective for Teaching Paramedic Students Endotracheal Intubation

ACADEMIC EMERGENCY MEDICINE, Issue 9 2005
FRCPC, Robert E. Hall BSc
Abstract Objectives: The primary purpose of this study was to determine whether the endotracheal intubation (ETI) success rate is different among paramedic students trained on a human patient simulator versus on human subjects in the operating room (OR). Methods: Paramedic students (n= 36) with no prior ETI training received identical didactic and mannequin teaching. After randomization, students were trained for ten hours on a patient simulator (SIM) or with 15 intubations on human subjects in the OR. All students then underwent a formalized test of 15 intubations in the OR. The primary outcome was the rate of successful intubation. Secondary outcomes were the success rate at first attempt and the complication rate. The study was powered to detect a 10% difference for the overall success rate (,= 0.05, ,= 0.20). Results: The overall intubation success rate was 87.8% in the SIM group and 84.8% in the OR group (difference of 3.0% [95% confidence interval {CI} =,4.2% to 10.1%; p = 0.42]). The success rate on the first attempt was 84.4% in the SIM group and 80.0% in the OR group (difference of 4.4% [95% CI =,3.4% to 12.3%; p = 0.27]). The complication rate was 6.3% in the SIM group and 4.4% in the OR group (difference of 1.9% [95% CI =,2.9% to 6.6%; p = 0.44]). Conclusions: When tested in the OR, paramedic students who were trained in ETI on a simulator are as effective as students who trained on human subjects. The results support using simulators to teach ETI. [source]

The Usefulness of Design of Experimentation in Defining the Effect Difficult Airway Factors and Training Have on Simulator Oral,Tracheal Intubation Success Rates in Novice Intubators

Video-laryngoscopes in the adult airway management: a topical review of the literature

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2010
P. NIFOROPOULOU
The aim of the present paper is to review the literature regarding video-laryngoscopes (Storz V-Mac and C-Mac, Glidescope, McGrath, Pentax-Airway Scope, Airtraq and Bullard) and discuss their clinical role in airway management. Video-laryngoscopes are new intubation devices, which provide an indirect view of the upper airway. In difficult airway management, they improve Cormack,Lehane grade and achieve the same or a higher intubation success rate in less time, compared with direct laryngoscopes. Despite the very good visualization of the glottis, the insertion and advancement of the endotracheal tube with video-laryngoscopes may occasionally fail. Each particular device's features may offer advantages or disadvantages, depending on the situation the anaesthesiologist has to deal with. So far, there is inconclusive evidence indicating that video-laryngoscopy should replace direct laryngoscopy in patients with normal or difficult airways. [source]

A comparison of bonfils fiberscope-assisted laryngoscopy and standard direct laryngoscopy in simulated difficult pediatric intubation: a manikin study

PEDIATRIC ANESTHESIA, Issue 6 2010
ARNIM VLATTEN MD
Summary Introduction:, Difficult airway management in children is challenging. One alternative device to the gold standard of direct laryngoscopy is the STORZ Bonfils fiberscope (Karl Storz Endoscopy, Tuttlingen, Germany), a rigid fiberoptic stylette-like scope with a curved tip. Although results in adults have been encouraging, reports regarding its use in children have been conflicting. We compared the effectiveness of a standard laryngoscope to the Bonfils fiberscope in a simulated difficult infant airway. Methods:, Ten pediatric anesthesiologists were recruited for this study and asked to perform three sets of tasks. For the first task, each participant intubated an unaltered manikin (SimBaby TM, Laerdal, Puchheim, Germany) five times using a styletted 3.5 endotracheal tube (ETT) and a Miller 1 blade (group DL-Normal). For the second task, a difficult airway configuration simulating a Cormack-Lehane grade 3B view was created by fixing a Miller-1 blade into position in the manikin using a laboratory stand. Each participant then intubated the manikin five times with a styletted 3.5 ETT using conventional technique but without touching the laryngoscope (group DL-Difficult). In the third task, the manikin was kept in the same difficult airway configuration, and each participant intubated the manikin five times using a 3.5-mm ETT mounted on the Bonfils fiberscope as an adjunct to direct laryngoscopy with the Miller-1 blade (group BF-Difficult). Primary outcomes were time to intubate and success rate. Results:, A total of 150 intubations were performed. Correct ETT placement was achieved in 100% of attempts in group DL-Normal, 90% of attempts in group DL-Difficult and 98% of attempts in BF-Difficult. Time to intubate averaged 14 s (interquartile range 12,16) in group DL-Normal; 12 s (10,15) in group DL-Difficult; and 11 s (10,18) in group BF-Difficult. The percentage of glottic opening seen (POGO score) was 70% (70,80) in group DL-Normal; 0% (0,0) in group DL-Difficult; and 100% (100,100) in group BF-Difficult. Discussion:, The Bonfils fiberscope-assisted laryngoscopy was easier to use and provided a better view of the larynx than simple direct laryngoscopy in the simulated difficult pediatric airway, but intubation success rate and time to intubate were not improved. Further studies of the Bonfils fibrescope as a pediatric airway adjunct are needed. [source]

A comparison of the Airway Scope® and McCoy laryngoscope in patients with simulated restricted neck mobility

ANAESTHESIA, Issue 6 2010
R. Komatsu
Summary We compared the efficacy of the Airway Scope® and McCoy laryngoscope as intubation tools with the neck stabilised by a rigid cervical collar. After induction of anaesthesia and neck stabilisation, 100 patients were randomly assigned to tracheal intubation with an Airway Scope or McCoy laryngoscope. Overall intubation success rate, time required for intubation, number of intubation attempts required for successful intubation, and airway complications related to intubation were recorded. Overall intubation success rates were 100% with both devices and a similar number of intubation attempts were required. However, the mean (SD) time required for successful intubation was shorter with the Airway Scope (30 (7) s) than with the McCoy laryngoscope (40 (14) s; p < 0.0001). The incidences of intubation complications were similar, but oesophageal intubation (in six cases) occurred only with McCoy laryngoscope. [source]

Optimising tracheal intubation success rate using the Airtraq laryngoscope

ANAESTHESIA, Issue 3 2009
G. Dhonneur
Summary In this study we have used a video-recording, retrospective analysis technique to evaluate the influence of the AirtraqÔ laryngoscope manipulations and the resulting changes in position of the glottic opening and inter-arytenoids cleft, on the success rate of tracheal intubation. The video recordings of the internal views of 109 tracheal intubation attempts, in 50 anaesthetised patients were analysed. We demonstrated that successful tracheal intubation using the Airtraq laryngoscope require the glottic opening to be centred in the view, and positioning the inter-arytenoid cleft medially below the horizontal line in the centre of the view. We also demonstrated that repositioning of the Airtraq laryngoscope following a failed tracheal intubation attempt required the performance of a standard series of manoeuvres. [source]

Impact of Emergency Medicine Faculty and an Airway Protocol on Airway Management

ACADEMIC EMERGENCY MEDICINE, Issue 12 2002
James H. Jones MD
Objective: To determine the impact of emergency medicine (EM) faculty presence and an airway management protocol on success rates of tracheal intubation in the emergency department (ED). Methods: A retrospective observational study of prospectively collected data on rates of successful intubations between June 1997 and December 2001 in the ED of a large urban teaching hospital. The authors compared success rates of the first attempt at intubation and times to intubation prior to and after EM faculty presence and the institution of an airway management protocol. Results: Prior to EM faculty presence and the airway management protocol, tracheal intubation was achieved on the first attempt 46% of the time; more than six attempts were required 2.9% of the time. The mean time to intubation was 9.2 minutes (±13.2 SD). Following EM faculty presence and the airway protocol, the success rate on the first attempt was 62%, more than six attempts were required 1.1% of the time, and the mean time to intubation was 4.6 minutes (±6.2 SD). Conclusions: First-attempt intubation success rates and decreased mean time to successful intubation improved following EM faculty presence and the introduction of an airway management protocol. [source]

The Usefulness of Design of Experimentation in Defining the Effect Difficult Airway Factors and Training Have on Simulator Oral,Tracheal Intubation Success Rates in Novice Intubators

A comparison of the Airway Scope® and McCoy laryngoscope in patients with simulated restricted neck mobility

Comparison of the Glidescope® and Airtraq® optical laryngoscopes in patients undergoing direct microlaryngoscopy

ANAESTHESIA, Issue 3 2009
M. Lange
Summary Optical laryngoscopes have been developed to facilitate difficult airway management. The Airtraq® is a single-use device and the GlideScope® is reusable. In this study, the Airtraq and the Glidescope were compared in 60 ASA I-III patients with tumours of the upper airway undergoing direct endoscopic microlaryngoscopy. Patients were randomly assigned to the Airtraq or the Glidescope group and the Cormack and Lehane grade was assessed by Macintosh laryngoscopy prior to tracheal intubation. There were no differences in tracheal intubation success rates or duration of intubation attempts between both devices. The Cormack and Lehane grade was improved in 77% and 82% of cases in the Airtraq and Glidescope group, respectively. Blood traces on the device and traumatic pharyngeal lesions were found more frequently in the Airtraq group. The Airtraq and Glidescope laryngoscopes are valuable tools for the management of patients with potentially difficult airways with the Glidescope appearing to be less traumatic. [source]