Kim Jae Guk, Kim Wonhee, Kang Gu Hyun, Jang Yong Soo, Choi Hyun Young, Kim Hyeongtae, Kim Minji
Department of Emergency Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Clin Exp Emerg Med. 2018 Mar 30;5(1):29-34. doi: 10.15441/ceem.16.188. eCollection 2018 Mar.
This study aimed to evaluate the efficacy of i-gel blind intubation (IGI) as a rescue device for definitive airway management in ground intubation for pre-hospital trauma patients.
A prospective randomized crossover study was conducted with 18 paramedics to examine intubation performance of two blind intubation techniques through a supraglottic airway devices (IGI and laryngeal mask airway Fastrach), compared with use of a Macintosh laryngoscope (MCL). Each intubation was conducted at two levels of patient positions (ground- and stretcher-level). Primary outcomes were the intubation time and the success rate for intubation.
The intubation time (sec) of each intubation technique was not significantly different between the two positions. In both patient positions, the intubation time of IGI was shortest among the three intubation techniques (17.9±5.2 at the ground-level and 16.9±3.8 at the stretcher-level). In the analysis of cumulative success rate and intubation time, IGI was the fastest to reach 100% success among the three intubation techniques regardless of patient position (all P<0.017). The success of intubation was only affected by the intubation technique, and IGI achieved more success than MCL (odds ratio, 3.6; 95% confidence interval, 1.1 to 11.6; P=0.03).
The patient position did not affect intubation performance. Additionally, the intubation time with blind intubation through supraglottic airway devices, especially with IGI, was significantly shorter than that with MCL.
本研究旨在评估i-gel盲探插管（IGI）作为院前创伤患者地面插管确定性气道管理救援设备的有效性。
对18名护理人员进行了一项前瞻性随机交叉研究，通过声门上气道装置（IGI和喉罩气道Fastrach）与使用Macintosh喉镜（MCL）相比，检查两种盲探插管技术的插管性能。每次插管在患者的两个体位水平（地面和担架水平）进行。主要结局是插管时间和插管成功率。
两种体位下，每种插管技术的插管时间差异无统计学意义。在两个患者体位中，IGI的插管时间在三种插管技术中最短（地面水平为17.9±5.2秒，担架水平为16.9±3.8秒）。在累积成功率和插管时间分析中，无论患者体位如何，IGI在三种插管技术中达到100%成功的速度最快（所有P<0.017）。插管成功仅受插管技术影响，IGI比MCL成功率更高（优势比，3.6；95%置信区间，1.1至11.6；P=0.03）。
患者体位不影响插管性能。此外，通过声门上气道装置进行盲探插管，尤其是IGI，其插管时间明显短于MCL。
