Frascone R J, Pippert Greg, Heegaard William, Molinari Paul, Dries David
LifeLink III, Minneapolis, MN, USA.
Air Med J. 2008 Jul-Aug;27(4):185-7. doi: 10.1016/j.amj.2007.11.002.
To evaluate laryngeal mask airway (LMA) and intubating laryngeal mask airway (ILMA) placement by helicopter emergency medical services (HEMS) personnel after a comprehensive training program.
HEMS flight staff attended a didactic and manikin-based training session for both devices. After this training, they attempted LMA and ILMA placement in live, anesthetized patients in an operating room (OR). Outcome measures included placement success rates with the LMA, ILMA, and endotracheal intubation through the ILMA, time to ventilation, and time to intubation. Success rates and time to ventilation were compared using chi-squared and analysis of variance (ANOVA), respectively. Mean time to ventilation for the first and second placements of both devices was examined with repeated measures ANOVA.
There was no difference in successful placement of the LMA compared with the ILMA (100% vs. 91%, P = .15). Ninety-five percent (19/20) of patients were successfully intubated through the ILMA. Time to intubation was 57.1 +/- 55 seconds (range, 20-240). Mean time to ventilation with either device did not differ significantly (36.8 +/- 17 vs. 38.05 +/- 20 seconds; P = .29). Mean time to ventilation for the first and second placement of either the LMA (P = .45) or the ILMA (P = .47) was not statistically different.
Trained HEMS flight staff are capable of effectively placing the LMA and ILMA in the operating room after a comprehensive training protocol.
通过一项全面培训计划,评估直升机紧急医疗服务(HEMS)人员放置喉罩气道(LMA)和插管型喉罩气道(ILMA)的情况。
HEMS飞行人员参加了针对这两种设备的理论及模拟人培训课程。培训结束后,他们在手术室对正在接受麻醉的患者尝试放置LMA和ILMA。观察指标包括LMA、ILMA的放置成功率,通过ILMA进行气管插管的成功率、通气时间和插管时间。分别使用卡方检验和方差分析(ANOVA)比较成功率和通气时间。使用重复测量方差分析检查两种设备首次和第二次放置的平均通气时间。
LMA与ILMA的成功放置率无差异(100%对91%,P = 0.15)。95%(19/20)的患者通过ILMA成功插管。插管时间为57.1±55秒(范围20 - 240秒)。两种设备的平均通气时间无显著差异(36.8±17秒对38.05±20秒;P = 0.29)。LMA或ILMA首次和第二次放置的平均通气时间无统计学差异(LMA,P = 0.45;ILMA,P = 0.47)。
经过全面培训方案后,训练有素的HEMS飞行人员能够在手术室有效地放置LMA和ILMA。