Department of Emergency Medicine, University of Nebraska College of Medicine, Omaha, Nebraska(Wadman MC, Branecki CE, Barthold CL, Hoffman LH, Walker RA); Deaconess Medical Center, Spokane, Washington, USA (Dierks TW); Department of Epidemiology, University of Nebraska College of Public Health, Omaha, Nebraska, USA (Lander L); Department of Genetics, Cell Biology, and Anatomy, University of Nebraska College of Medicine, Omaha, Nebraska, USA (Lomneth CS).
World J Emerg Med. 2011;2(3):175-8. doi: 10.5847/wjem.j.1920-8642.2011.03.003.
Airway management in the emergency department is a critical intervention that requires both standard techniques and rescue techniques to ensure a high rate of success. Recently, video laryngoscope (VL) systems have become increasingly common in many large urban EDs, but these systems may exceed the budgets of smaller rural EDs and EMS services and the Airtraq optical laryngoscope (OL) may provide an effective, low-cost alternative. We hypothesized that laryngeal view and time to endothracheal tube placement for OL and VL intubations would not be significantly different.
This was a prospective, crossover trial.
University-based emergency medicine residency program procedure laboratory utilizing lightly embalmed cadavers.
PGY1-3 emergency medicine residents. The study subjects performed timed endotracheal intubations alternately using the OL and VL. The subjects then rated the Cormack-Lehane laryngeal view for each device.
Mean time to intubation and the mean laryngeal view score were calculated with 95% confidence intervals and statistical significance was determined by Student's t test.
Fourteen subjects completed the study. The average laryngeal view achieved with the OL vs. the VL was not significantly different, with Cormack-Lehane grade of 1.14 vs. 1.07, respectively. Time to endotracheal intubation, however, was significantly different (P<0.001) with the average time to intubation for the OL 25.49 seconds (95% CI: 17.95-33.03) and the VL 13.41 seconds (10.27-16.55).
The Airtraq OL and the Storz VL yielded similar laryngeal views in the lightly embalmed cadaver model. Time to endotracheal tube placement, however, was less for the VL.
在急诊科进行气道管理是一项关键干预措施，需要标准技术和救援技术来确保高成功率。最近，视频喉镜（VL）系统在许多大型城市急诊科中越来越常见，但这些系统可能超出了较小的农村急诊科和 EMS 服务的预算，而 Airtraq 光喉镜（OL）可能提供一种有效且低成本的替代方案。我们假设 OL 和 VL 插管的喉部显露和气管内导管放置时间不会有显著差异。
这是一项前瞻性、交叉试验。
在大学急诊医学住院医师计划程序实验室利用轻度防腐的尸体。
PGY1-3 急诊医学住院医师。研究对象使用 OL 和 VL 交替进行计时气管插管。然后，每位受试者对每种设备的 Cormack-Lehane 喉部显露进行评分。
使用 95%置信区间计算平均插管时间和平均喉部显露评分，并通过学生 t 检验确定统计学意义。
14 名受试者完成了研究。OL 与 VL 相比，OL 平均喉部显露评分与 VL 相比无显著差异，分别为 Cormack-Lehane 等级 1.14 和 1.07。然而，气管内插管时间差异显著（P<0.001），OL 的平均插管时间为 25.49 秒（95%CI：17.95-33.03），VL 的平均插管时间为 13.41 秒（10.27-16.55）。
在轻度防腐的尸体模型中，Airtraq OL 和 Storz VL 产生了相似的喉部显露。然而，VL 的气管内导管放置时间更短。
