Department of Emergency Medicine, Regions Hospital, St Paul, MN 55101, USA.
Am J Emerg Med. 2013 Mar;31(3):589-92. doi: 10.1016/j.ajem.2012.10.001. Epub 2013 Jan 21.
The aim of this study was to compare first-attempt and overall success rates and success rates in relation to placement time among 5 different airway management devices: Storz CMAC, Glidescope GVL, AirTraq, King LTS-D, and direct laryngoscopy (DL).
Emergency medical technician basic (EMT-B), EMT-paramedics (EMT-P), and emergency medicine residents and staff physicians placed each of the 5 devices in a random order into an AirSim (TruCorp, Belfast, UK) part-task training manikin. The difficult airway scenario was created by fixing the manikin head to a stationary object and introducing simulated emesis into the hypopharynx. First-attempt and overall success and success in relation to placement time were compared. Provider feedback about device performance was also evaluated.
Ninety-four providers (16 EMT-basics, 54 EMT-paramedics, and 24 emergency department doctors of medicine) consented to participation. First-attempt and overall success rates for DL, King LTS-D, GVL, and CMAC were not statistically different. Compared with DL, the AirTraq was 96% less likely to be placed successfully (odds ratio, 0.04; 95% confidence interval [CI], 0.01-0.14). When time was factored into the model, the odds of successful placement of the King LTS-D were higher compared with DL (hazard ratio [HR], 1.80; 95% CI, 1.34-2.42) and lower for GVL (HR, 0.59; 95% CI, 0.44-0.80) and AirTraq (HR, 0.228; 95% CI, 0.16-0.325). Providers ranked the CMAC first in terms of performance and preference for use in their practice setting.
Overall success rates for DL, King-LTS-D, and both video laryngoscope systems were not different. When time was factored into the model, the King LTS-D was more likely to be placed successfully.
本研究旨在比较 5 种不同气道管理设备（Storz CMAC、Glidescope GVL、AirTraq、King LTS-D 和直接喉镜（DL））的首次尝试和总成功率以及与放置时间相关的成功率。
急救医疗技术员基础（EMT-B）、急救医疗技术员-护理人员（EMT-P）以及急诊医学住院医师和主治医生以随机顺序将这 5 种设备中的每一种放入 AirSim（TruCorp，贝尔法斯特，英国）部分任务训练模拟人。通过将模拟人头固定在固定物体上并将模拟呕吐物引入咽下部来创建困难气道场景。比较首次尝试和总体成功率以及与放置时间相关的成功率。还评估了提供者对设备性能的反馈。
94 名提供者（16 名 EMT-B 基础，54 名 EMT-P 护理人员和 24 名医学急诊医生）同意参与。DL、King LTS-D、GVL 和 CMAC 的首次尝试和总体成功率没有统计学差异。与 DL 相比，AirTraq 成功放置的可能性低 96%（优势比，0.04；95%置信区间 [CI]，0.01-0.14）。当将时间纳入模型时，与 DL 相比，King LTS-D 成功放置的可能性更高（风险比[HR]，1.80；95%CI，1.34-2.42），而 GVL（HR，0.59；95%CI，0.44-0.80）和 AirTraq（HR，0.228；95%CI，0.16-0.325）的可能性更低。提供者根据性能将 CMAC 排名第一，并将其作为在实践环境中使用的首选。
DL、King-LTS-D 和两种视频喉镜系统的总体成功率没有差异。当将时间纳入模型时，King LTS-D 更有可能成功放置。
