Brooke Army Medical Center, JBSA Fort Sam Houston, TX.
Brooke Army Medical Center, JBSA Fort Sam Houston, TX; US Army Institute of Surgical Research, JBSA Fort Sam Houston, TX; Uniformed Services University of the Health Sciences, Bethesda, MD; and 59th Medical Wing, JBSA Lackland, TX.
Med J (Ft Sam Houst Tex). 2022 Apr-Jun(Per 22-04/05/06):22-26.
Airway obstruction is the second leading cause of potentially preventable death on the battlefield. Previous studies demonstrate the most frequent airway intervention is intubation. Currently, the US Army has advanced video laryngoscopy (VL) in its sets, kits, and outfits (SKOs) at a cost of approximately $12,000 and generally only deploys them to the forward resuscitative surgical detachments and field hospitals. The i-view is a disposable video laryngoscope that costs approximately $120. The purpose of this study was to assess operator performance with this device and survey user opinions.
We conducted a prospective, observational study with emergency medicine residents and attending physicians using a synthetic cadaver model. Placement success, time-to-cannulation, number of attempts, and number and type of complications were recorded, followed by surveys.
We enrolled 31 participants. One was missing data and was excluded, leaving 30 for analysis. The median age was 29, most (66%) were male, most were Air Force (57%), in-training residents (77%) with few reporting previous deployment experience (13%). Almost all had real patient experience with both direct (93%) and video laryngoscopy (90%). Most (90%) were able to get a grade 1 view with all achieving airway cannulation on first-pass attempt. The median time to cannulation was 11.6 seconds. On the post-procedure survey, most strongly agreed they would use this in the deployed setting (77%). Most reported they found it easy to use (77%).
Our simulation-based study demonstrates the device has strong potential use for the clinical setting with all achieving rapid first-pass success for intubation. This study lays the foundation for validation of this device in the clinical setting.
气道阻塞是战场上第二个潜在可预防的死亡原因。先前的研究表明，最常见的气道干预措施是插管。目前，美国陆军在其集装包和成套装备中配备了先进的视频喉镜（VL），成本约为 12000 美元，通常只部署到前方复苏手术分离点和野战医院。i-view 是一种一次性视频喉镜，成本约为 120 美元。本研究旨在评估该设备的操作人员性能并调查用户意见。
我们使用合成尸体模型进行了一项前瞻性、观察性研究，研究对象为急诊医学住院医师和主治医生。记录了放置成功率、插管时间、尝试次数、并发症的数量和类型，然后进行了调查。
我们共招募了 31 名参与者。其中 1 人数据缺失，被排除在外，因此有 30 人进行了分析。中位数年龄为 29 岁，大多数（66%）为男性，大多数为空军（57%），在培训住院医师（77%），很少有人有之前部署的经验（13%）。几乎所有人都有直接（93%）和视频喉镜（90%）的真实患者经验。大多数（90%）人能够获得 1 级视野，所有人都在首次尝试时实现了气道插管。插管时间中位数为 11.6 秒。在术后调查中，大多数人强烈表示他们会在部署环境中使用该设备（77%）。大多数人表示他们发现该设备易于使用（77%）。
我们的基于模拟的研究表明，该设备在临床环境中有很强的潜在用途，所有患者都能快速实现首次插管成功。这项研究为该设备在临床环境中的验证奠定了基础。
