Nasim Sajid, Maharaj Chrisen H, Butt Ihsan, Malik Muhammad A, O' Donnell John, Higgins Brendan D, Harte Brian H, Laffey John G
Department of Anaesthesia, Galway University Hospitals, Galway, Ireland.
BMC Emerg Med. 2009 Feb 13;9:2. doi: 10.1186/1471-227X-9-2.
Paramedics are frequently required to perform tracheal intubation, a potentially life-saving manoeuvre in severely ill patients, in the prehospital setting. However, direct laryngoscopy is often more difficult in this environment, and failed tracheal intubation constitutes an important cause of morbidity. Novel indirect laryngoscopes, such as the Airtraq and Truview laryngoscopes may reduce this risk.
We compared the efficacy of these devices to the Macintosh laryngoscope when used by 21 Paramedics proficient in direct laryngoscopy, in a randomized, controlled, manikin study. Following brief didactic instruction with the Airtraq and Truview laryngoscopes, each participant took turns performing laryngoscopy and intubation with each device, in an easy intubation scenario and following placement of a hard cervical collar, in a SimMan manikin.
The Airtraq reduced the number of optimization manoeuvres and reduced the potential for dental trauma when compared to the Macintosh, in both the normal and simulated difficult intubation scenarios. In contrast, the Truview increased the duration of intubation attempts, and required a greater number of optimization manoeuvres, compared to both the Macintosh and Airtraq devices.
The Airtraq laryngoscope performed more favourably than the Macintosh and Truview devices when used by Paramedics in this manikin study. Further studies are required to extend these findings to the clinical setting.
在院前环境中，急救人员经常需要对重症患者进行气管插管，这是一项可能挽救生命的操作。然而，在这种环境下直接喉镜检查往往更困难，气管插管失败是发病的一个重要原因。新型间接喉镜，如Airtraq喉镜和Truview喉镜，可能会降低这种风险。
在一项随机对照模拟人研究中，我们比较了21名精通直接喉镜检查的急救人员使用这些设备与Macintosh喉镜的效果。在对Airtraq喉镜和Truview喉镜进行简短的教学指导后，每位参与者轮流使用每种设备在简单插管场景下以及在SimMan模拟人上放置硬颈托后进行喉镜检查和插管。
在正常和模拟困难插管场景中，与Macintosh喉镜相比，Airtraq喉镜减少了优化操作的次数，并降低了牙齿损伤的可能性。相比之下，与Macintosh喉镜和Airtraq喉镜设备相比，Truview喉镜增加了插管尝试的持续时间，并且需要更多的优化操作。
在这项模拟人研究中，急救人员使用时，Airtraq喉镜比Macintosh喉镜和Truview喉镜表现更优。需要进一步研究将这些发现扩展到临床环境。
