Schauer Steven G, Davis William T, Johnson Michelle D, Escandon Mireya A, Uhaa Nguvan, Maddry Joseph K, Naylor Jason F, Van Arnem Kerri A, April Michael D
US Army Institute of Surgical Research, JBSA Fort Sam Houston, TX 78234, USA.
Brooke Army Medical Center, JBSA Fort Sam Houston, TX 78236, USA.
Mil Med. 2022 May 3;187(5-6):e572-e576. doi: 10.1093/milmed/usaa537.
Airway obstruction is the second leading cause of preventable death on the battlefield. Video laryngoscopy has improved airway management in the emergency setting for several decades, and technology continues to improve. Current technology in the supply chain is cost-prohibitive to incorporate at Role 1 facilities, which is where many intubations occur by novice intubators. The i-view is a novel video laryngoscopy device that is handheld, inexpensive, and disposable. The aim of this study was to determine if the i-view is suitable based on performance assessments by physician assistant trainees and survey feedback.
We prospectively enrolled physician assistant students at the Interservice Physician Assistant Program at Joint Base San Antonio-Fort Sam Houston. We provided them structured training on how to use the device, and then, a board-certified emergency medicine physician or certified registered nurse anesthetist assessed their intubations performed on a SynDaver mannequin model. We surveyed the participants afterward.
We enrolled 60 Interservice Physician Assistant Program students. Most participants were male (75%) with a median age of 32 years. Service affiliations included Army (50%), Navy (23%), Air Force (18%), and Coast Guard (8%). Most (70%) had previous deployment experience. All the participants successfully cannulated the mannequins and 98% achieved first-attempt success. Most participants (78%) reported a grade 1 view. On postprocedure survey, 91% strongly agreed with using this device in the deployed setting and 89% strongly agreed with finding it easy to use.
All physician assistant trainees successfully and rapidly performed endotracheal intubation using the disposable i-view video laryngoscope. Study participants rated the device as easy to use and desirable for deployment. Further research is necessary to validate this novel device in the clinical setting before recommending dissemination to the deployed military medical force sets, kits, and outfits.
气道梗阻是战场上可预防死亡的第二大主要原因。几十年来，视频喉镜改善了急诊环境中的气道管理，且技术仍在不断进步。供应链中的现有技术成本过高，无法在一级医疗机构采用，而许多插管操作是由新手插管人员在一级医疗机构进行的。i-view是一种新型的视频喉镜设备，它手持、价格低廉且为一次性使用。本研究的目的是根据医师助理学员的性能评估和调查反馈来确定i-view是否适用。
我们前瞻性地招募了圣安东尼奥 - 萨姆休斯顿联合基地三军医师助理项目的医师助理学生。我们为他们提供了关于如何使用该设备的结构化培训，然后，一名获得董事会认证的急诊医学医师或认证注册护士麻醉师评估他们在SynDaver人体模型上进行的插管操作。之后我们对参与者进行了调查。
我们招募了60名三军医师助理项目的学生。大多数参与者为男性（75%），中位年龄为32岁。军种所属包括陆军（50%）、海军（23%）、空军（18%）和海岸警卫队（8%）。大多数（70%）有过部署经验。所有参与者均成功地在人体模型上插入导管，98%的人首次尝试即获成功。大多数参与者（78%）报告视野为1级。在术后调查中，91%的人强烈同意在部署环境中使用该设备，89%的人强烈同意认为该设备易于使用。
所有医师助理学员均使用一次性i-view视频喉镜成功且快速地进行了气管插管。研究参与者将该设备评为易于使用且适合部署。在建议向部署的军事医疗部队的装备、套件和服装中推广之前，有必要进行进一步研究以在临床环境中验证这一新型设备。
