Wackett Andrew, Anderson Kaj, Thode Henry
Department of Emergency Medicine, University Hospital Stony Brook, Stony Brook, New York 11794, USA.
J Emerg Med. 2005 Oct;29(3):253-7. doi: 10.1016/j.jemermed.2005.01.025.
To determine ease of Bullard laryngoscopy by naïve operators during cervical spine immobilization, 21 residents, naïve to the Bullard laryngoscope, were assigned to perform Bullard laryngoscopy and standard direct laryngoscopy on the Laerdal SimMan Universal Patient Simulator while the rigid cervical spine function was engaged. Sequences were repeated. Success of laryngeal intubation, time to intubation, ease of intubation, and grade of laryngoscopic view were recorded and compared. Pairwise comparisons of consecutive times between standard and Bullard devices showed significant difference in mean times at first attempt, 28.8 (95% confidence interval [CI] 18.1-39.5) seconds in favor of Macintosh laryngoscopy, but no statistical differences between devices at second and third attempts, with differences in mean times of 4.5 (95% CI 2.5-6.5) and 3.8 (95% CI, 0.1-7.7) seconds, respectively. Similarly, ease of use was statistically unchanged over time for Macintosh laryngoscopy, but there was statistically significant improvement in ease of use for the Bullard. The Bullard laryngoscope is an easily mastered airway management device for intubation of the cervical spine immobilized patient.
为了确定在颈椎固定期间新手操作者使用Bullard喉镜的难易程度，将21名对Bullard喉镜不熟悉的住院医师分配到Laerdal SimMan通用患者模拟器上，在颈椎功能固定的情况下进行Bullard喉镜检查和标准直接喉镜检查。操作顺序重复进行。记录并比较了喉插管成功率、插管时间、插管难易程度和喉镜视野分级。标准喉镜和Bullard喉镜连续使用时间的两两比较显示，首次尝试时平均时间有显著差异，28.8秒（95%置信区间[CI]18.1 - 39.5），Macintosh喉镜更具优势，但第二次和第三次尝试时两种设备之间无统计学差异，平均时间差异分别为4.5秒（95%CI 2.5 - 6.5）和3.8秒（95%CI 0.1 - 7.7）。同样，Macintosh喉镜的易用性随时间在统计学上无变化，但Bullard喉镜的易用性有统计学上的显著改善。Bullard喉镜是一种易于掌握的气道管理设备，用于颈椎固定患者的插管。
