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新手在颈椎固定人体模型上使用麦格拉斯®5系列视频喉镜进行气管插管

Tracheal Intubation with a McGrath® Series 5 Video Laryngoscope by Novice Personnel in a Cervical-immobilized Manikin.

作者信息

Choi Ji Won, Kim Jie Ae, Jung Hyun Joo, Kim Won Ho

机构信息

Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

Department of Anesthesiology and Pain Medicine, Changwon Samsung Hospital, Sungkyunkwan University School of Medicine, Changwon-si, Gyeongsangnam-do, South Korea.

出版信息

J Emerg Med. 2016 Jan;50(1):61-6. doi: 10.1016/j.jemermed.2015.06.079. Epub 2015 Oct 1.

Abstract

BACKGROUND

Prehospital tracheal intubation may be performed by novice intubators in cervical immobilized patients. However, most indirect laryngoscopes require special training. The McGrath® Series 5 video laryngoscope is similar to the Macintosh laryngoscope in shape and usage, yet still confers the advantages of having indirect laryngoscopes.

OBJECTIVE

This study compared tracheal intubation by novice users, using the McGrath® Series 5 video laryngoscope vs. the Macintosh laryngoscope in a cervical immobilized manikin.

METHODS

Thirty-eight nurses intubated the trachea of a manikin using a McGrath® Series 5 video laryngoscope and a Macintosh laryngoscope, in random order. Then they repeated the procedure in a manikin with a cervical collar. Success rate, time to success, number of intubation attempts, dental clicks, and difficulty score were compared between the two laryngoscopes.

RESULTS

First-attempt success rate was higher for the McGrath® Series 5 compared to the Macintosh laryngoscope in cervical immobilizations (84.2% vs. 47.7%, respectively; p = 0.019). However, overall intubation success rate with and without the cervical collar was no different. Tracheal intubation using the McGrath® Series 5 was faster than the Macintosh laryngoscope regardless of the presence of a cervical collar. McGrath® Series 5 required fewer trials, had fewer dental clicks, and was easier to use than the Macintosh laryngoscope.

CONCLUSIONS

McGrath® Series 5 video laryngoscope may be better than a standard Macintosh laryngoscope for novice intubators intubating the trachea in cervical immobilization, due to the higher first-attempt success rate, faster intubation time, fewer dental clicks, lower number of intubation attempts, and overall ease of use.

摘要

背景

在颈椎固定患者中,院前气管插管可能由新手插管人员进行。然而,大多数间接喉镜需要特殊培训。麦格拉斯®5系列视频喉镜在形状和使用方法上与麦金托什喉镜相似,但仍具有间接喉镜的优点。

目的

本研究比较了新手使用者在颈椎固定人体模型上使用麦格拉斯®5系列视频喉镜与麦金托什喉镜进行气管插管的情况。

方法

38名护士以随机顺序使用麦格拉斯®5系列视频喉镜和麦金托什喉镜对人体模型进行气管插管。然后他们在佩戴颈托的人体模型上重复该操作。比较两种喉镜的成功率、成功时间、插管尝试次数、牙齿碰撞声和困难评分。

结果

在颈椎固定情况下,麦格拉斯®5系列的首次尝试成功率高于麦金托什喉镜(分别为84.2%和47.7%;p = 0.019)。然而,有无颈托时的总体插管成功率并无差异。无论有无颈托,使用麦格拉斯®5系列进行气管插管都比麦金托什喉镜更快。麦格拉斯®5系列所需的尝试次数更少,牙齿碰撞声更少,且比麦金托什喉镜更易于使用。

结论

对于在颈椎固定情况下进行气管插管的新手插管人员,麦格拉斯®5系列视频喉镜可能优于标准的麦金托什喉镜,因为其首次尝试成功率更高、插管时间更快、牙齿碰撞声更少、插管尝试次数更少且总体易于使用。

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