Centre for Prehospital Emergency Care, Kuopio University Hospital, P.O. Box 1777, FI-70210 KYS, Kuopio, Finland.
Resuscitation. 2013 Apr;84(4):446-9. doi: 10.1016/j.resuscitation.2012.08.326. Epub 2012 Aug 31.
Airway management is of major importance in prehospital emergency care. Bag-valve mask (BVM) ventilation and endotracheal intubation (ETI) have been shown to be difficult, especially when caregivers are inexperienced. Alternative methods have been studied, and supraglottic devices have been shown to provide reasonable ease of placement and effective ventilation in manikin studies and anaesthetised patients. First responders (FR) are employed by many emergency medical services (EMS) to shorten initiation of emergency care, and they are trained to provide basic CPR including BVM and use of automated external defibrillators (AED) in case of out-of-hospital cardiac arrest (OCHA). The aim of this research was to study the feasibility of manikin-trained FRs using a laryngeal tube (LT) as a primary airway method during cardiac arrest. We trained 300 FRs to use a LT during OHCA. The FRs used a LT in 64 OHCA cases. The LT was correctly placed on the first attempt in 46/64 cases (71.9%) and on the second attempt in 13/64 cases (20.3%). Insertion was reported as being easy in 55/64 cases (85.9%). Median insertion time was 23.1s, with a range of 3-240s. We found that after manikin training, the FRs inserted the LT and performed adequate ventilation with a reasonable success rate and insertion time.
气道管理在院前急救中至关重要。已经证明，球囊面罩通气（BVM）和气管插管（ETI）操作困难，尤其是在护理人员缺乏经验的情况下。已经研究了替代方法，并且在人体模型研究和麻醉患者中已经证明，声门上设备易于放置并且能够有效通气。许多紧急医疗服务（EMS）机构都雇佣急救人员（FR）来缩短急救的启动时间，并且他们接受过培训，可以在院外心脏骤停（OCHA）的情况下提供基本的心肺复苏（CPR），包括 BVM 和使用自动体外除颤器（AED）。本研究旨在研究在心脏骤停期间使用喉管（LT）作为主要气道方法的经过人体模型培训的 FR 的可行性。我们培训了 300 名 FR 使用 LT 进行 OHCA。FR 在 64 例 OHCA 中使用 LT。LT 在 46/64 例（71.9%）中首次尝试正确放置，在 13/64 例（20.3%）中第二次尝试正确放置。在 55/64 例（85.9%）中报告插入容易。中位插入时间为 23.1s，范围为 3-240s。我们发现，经过人体模型培训后，FR 插入 LT 并进行了足够的通气，成功率和插入时间合理。
