Tienpratarn Welawat, Yuksen Chaiyaporn, Aramvanitch Kasamon, Suttapanit Karn, Mankong Yahya, Yaemluksanalert Nussareen, Meesawad Sansanee
Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
Arch Acad Emerg Med. 2020 Oct 10;8(1):e81. eCollection 2020.
Application of a rigid cervical collar may interfere with the laryngeal view, and potentially lead to failed endotracheal intubation (ETI). This study aimed to compare intubation success rates while performing inline stabilization with and without cervical hard collar.
This randomized prospective comparative study included paramedics working in the Department of Emergency Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand to compare the success rates of endotracheal intubation on manikin using inline stabilization with and without cervical hard collar.
125 participants were evaluated; 63 in the rigid cervical collar and 62 in the non-cervical hard collar group. The rate of successful intubation was significantly higher using manual stabilization without cervical hard collar (61 (96.8%) vs. 55 (88.7%); p=0.048). The time required to successfully perform intubation was also shorter, with manual stabilization only (14.1 ±20.9 vs. 18.9±29.0; p = 0.081).
It seems that, removal of the rigid cervical collar during ETI in patients with suspected traumatic spine injury could increase the intubation success rate.
使用硬质颈托可能会干扰喉镜视野，并有可能导致气管插管失败。本研究旨在比较在有和没有硬质颈托的情况下进行轴向固定时的插管成功率。
这项随机前瞻性对照研究纳入了泰国曼谷玛希隆大学拉玛提波迪医院急诊科的护理人员，以比较在有和没有硬质颈托的情况下对人体模型进行轴向固定时气管插管的成功率。
对125名参与者进行了评估；63人佩戴硬质颈托，62人未佩戴硬质颈托。不使用硬质颈托进行手动固定时的插管成功率显著更高（61例（96.8%）对55例（88.7%）；p=0.048）。成功完成插管所需的时间也更短，仅使用手动固定时（14.1±20.9对18.9±29.0；p=0.081）。
对于疑似脊柱外伤患者，在气管插管期间移除硬质颈托似乎可以提高插管成功率。
