Department of Emergency Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Prehosp Emerg Care. 2011 Jan-Mar;15(1):98-103. doi: 10.3109/10903127.2010.514087. Epub 2010 Oct 29.
To evaluate whether chest compressions affect the time taken for intubation (TTI) using the Macintosh laryngoscope and two portable video laryngoscopes (VLs) (GlideScope Ranger and Airway Scope) when used by novice prehospital caregivers, and to compare the TTIs and rates of successful intubation among the three laryngoscopes with and without chest compressions in a manikin model.
This was a pilot randomized crossover study. Twenty paramedic students and paramedics who had no clinical experience with tracheal intubation and had never used any of two VLs participated in the study. After a one-hour training session for the VLs, participants performed intubations on a Laerdal Resusci Anne Simulator placed on the floor. Each paramedic used all three laryngoscopes, with the order of usage being randomly assigned. The TTIs and rates of successful intubation among the three laryngoscopes, with and without ongoing chest compressions, were compared.
The difference between the TTIs using each laryngoscope with and without chest compressions was not significant (Macintosh: 2.99 sec, p = 0.06; GlideScope Ranger: 2.04 sec, p = 0.11; and Airway Scope: 0.91 sec, p = 0.10). The median TTI using the Airway Scope (15.46 sec) was significantly shorter than those for the Macintosh (24.14 sec) and the GlideScope Ranger (24.12 sec) during chest compressions (p = 0.028 and p = 0.004, respectively). There were no significant differences in the rates of successful intubation among the three laryngoscopes on each condition (without chest compressions, p = 0.15; with chest compressions, p = 0.27), but the cumulative success rates related to the TTI were significantly greater with the Airway Scope than with the other devices in both conditions.
In this pilot study, chest compressions did not significantly affect the TTI using the Macintosh laryngoscope and two portable VLs when used by novice prehospital caregivers in the manikin model on the floor. Considering the fairly short training time, two portable VLs may be potentially useful adjuncts for tracheal intubation during chest compressions for novice prehospital caregivers. Further studies are required to validate whether these findings are clinically relevant.
评估在使用 Macintosh 喉镜和两种便携式视频喉镜（GlideScope Ranger 和 Airway Scope）时，新手院前护理人员进行胸外按压是否会影响插管时间（TTI），并比较在模拟人体模型上有无胸外按压时三种喉镜的 TTI 和插管成功率。
这是一项初步的随机交叉研究。20 名没有气管插管临床经验且从未使用过两种 VL 之一的护理专业学生和护理人员参加了研究。在接受了 VL 一个小时的培训后，参与者在放在地板上的 Laerdal Resusci Anne 模拟器上进行插管。每位护理人员使用三种喉镜，使用顺序随机分配。比较三种喉镜在有无持续胸外按压时的 TTI 和插管成功率。
在有或没有胸外按压的情况下使用每种喉镜的 TTI 之间没有显著差异（Macintosh：2.99 秒，p = 0.06；GlideScope Ranger：2.04 秒，p = 0.11；和 Airway Scope：0.91 秒，p = 0.10）。在进行胸外按压时，使用 Airway Scope 的 TTI 中位数（15.46 秒）明显短于 Macintosh（24.14 秒）和 GlideScope Ranger（24.12 秒）（分别为 p = 0.028 和 p = 0.004）。在每种情况下，三种喉镜的插管成功率之间没有显著差异（无胸外按压时，p = 0.15；有胸外按压时，p = 0.27），但在两种情况下，与其他设备相比，Airway Scope 的累积成功率与 TTI 相关，均明显更高。
在这项初步研究中，在模拟人体模型上，在地板上使用时，新手院前护理人员进行胸外按压不会显著影响 Macintosh 喉镜和两种便携式 VL 的 TTI。考虑到相当短的培训时间，两种便携式 VL 可能是新手院前护理人员在进行胸外按压时进行气管插管的潜在有用辅助工具。需要进一步的研究来验证这些发现是否具有临床意义。
