Article Data

  • Views 208
  • Dowloads 4

Original Research

Open Access

The influence of different airway management strategies on chest compression fraction in simulated cardiopulmonary resuscitation, provided by paramedics: LMA Supreme versus Endotracheal Intubation and Combitube

  • EWELINA GASZYNSKA1
  • TOMASZ GASZYNSKI2

1Department of Hygiene and Health Promotion, Medical University of Lodz

2,Barlicki University Hospital

DOI: 10.22514/SV91.042014.3 Vol.9,Issue 1,April 2014 pp.22-26

Published: 30 April 2014

*Corresponding Author(s): TOMASZ GASZYNSKI E-mail: tomasz.gaszynski@umed.lodz.pl

Abstract

Introduction. It is strongly advised by the European Resuscitation Council not to interrupt chest compressions for airway management. An alternative to tracheal intubation is the use of a supraglottic airway device (SAD) which should shorten “hands-off” time during cardiopulmonary resuscitation (CPR). Chest compression fraction (CCF) should be above 0.6 to ensure the probability of successful CPR. We compared the performance of airway management during CPR provided by paramedics using the laryngeal mask (LMA) Supreme, Combitube and endotracheal intubation (ET) in a manikin model. Materials and Methods. Thirty sophomore students of emergency medicine school for paramedics took part in the study. The primary endpoint was to assess the influence of the type of airway management on CCF. The time to successful airway management (TA) was measured and the minute ventilation was assessed using the respirator Medumat Easy and program AMBU® CPR SOFTWARE during uninterrupted CPR. CCF was measured using CPRmeter - QCPR (Laerdal).

Results. Mean CCF was significantly better for LMA Supreme (0.8 vs 0.71 vs 0.65), mean TA was significantly shorter for LMA supreme: 16.5 sec vs 24.37 sec vs 28,3 sec, the success rate in the first attempt was 100% vs 66.6% vs 100%, mean air leak during chest compressions was 14% vs 8% vs 15% for LMA Supreme, ET and Combitube respectively. Conclusion. The LMA Supreme is an effective tool for airway management during chest compression and provides adequ-ate ventilation.

Keywords

cardiopulmonary resusci-tation, airway management, endotra-cheal intubation, supraglottic devices

Cite and Share

EWELINA GASZYNSKA,TOMASZ GASZYNSKI. The influence of different airway management strategies on chest compression fraction in simulated cardiopulmonary resuscitation, provided by paramedics: LMA Supreme versus Endotracheal Intubation and Combitube. Signa Vitae. 2014. 9(1);22-26.

References

1. Deakin CD, Nolan JP, Soar J, Sunde K, Koster RW, Smith GB, et al. European Resuscitation Council Guidelines for Resuscitation 2010 Section 4. Adult advanced life support. Resuscitation 2010;81(10):1305-52.

2. Burton HJ, Baumann MR, Maoz T, Bradshaw JR, Lebrun JE. Endotracheal intubation in a rural EMS state: procedure utilization and impact of skills maintenance guidelines. Prehosp Emerg Care 2003;7(3):352-6.

3. Vaillancourt C, Everson-Stewart S, Christenson J, Andrusiek D, Powell J, Nichol G, et al. The Impact of Increased Chest Compression Fraction on Return of Spontaneous Circulation for Out-of-Hospital Cardiac Arrest Patients not in Ventricular Fibrillation. Resuscitation 2011;82(12):1501–7.

4. Nolan JD. Prehospital and resuscitative airway care: should the gold standard be reassessed? Curr Opin Crit Care 2001;7(6):413-21.

5. Van Zundert A, Brimacombe J. Correspondence: The LMA Supreme™ – a pilot study. Anaesthesia 2008;63:202-13.

6. Schmidbauer W, Bercker S, Volk T, Bogusch G, Mager G, Kerner T. Oesophageal seal of the novel supralaryngeal airway device I-Gel™ in comparison with the laryngeal mask airways Classic and ProSeal using a cadaver model. Br J Anaesth 2009;102(1):135-9.

7. Gatward JJ, Thomas M JC, Nolan JP, Cook TM. Effect of chest compressions on the time taken to insert airway devices in a manikin. Br J Anaesth 2008;100(3):351-6.

8. Jensen JL, Walker M, LeRoux Y, Carter A. Chest compression fraction in simulated cardiac arrest management by primary care parame-dics: King laryngeal tube airway versus basic airway management. Prehosp Emerg Care 2013;17(2):285-90.

9. Kohama H, Komasawa N, Ueki R, Samma A, Nakagawa M, Nishi S, et al. Comparison of Supreme and Soft Seal laryngeal masks for airway management during cardiopulmonary resuscitation in novice doctors: a manikin study. J Anesth 2011; (25):98–103.

10. Gruber C, Nabecker S, Wohlfarth P, Ruetzler A, Roth D, Kimberger O, Fischer H, Frass M and Ruetzler K. Evaluation of airway management associated hands-off time during cardiopulmonary resuscitation: a randomised manikin follow-up study. Scand J Trauma Resusc Emerg Med 2013; 21:10.

11. Ruetzler K, Gruber C, Nabecker S, Wohlfarth P, Priemayr A, Frass M, et al. Hands-off time during insertion of six airway devices during cardiopulmonary resuscitation: a randomised manikin trial. Resuscitation 2011 Aug;82(8):1060-3.

12. Genzwuerker HV, Finteis T, Slabschi D, Groeschel J, Ellinger K. Assessment of the use of the laryngeal tube for cardiopulmonary resusci-tation in a manikin. Resuscitation 2001 Dec;51(3):291-6.

13. Ocker H, Wenzel V, Schmucker P, Dörges V. Effectiveness of various airway management techniques in a bench model simulating a cardiac arrest patient. J Emerg Med 2001 Jan;20(1):7-12.

14. Katz SH, Falk JL. Misplaced endotracheal tubes by paramedics in an urban emergency medical services system. Ann Emerg Med 2001;37:32–7.

15. Jones JH, Murphy MP, Dickson RL, Somerville GG, Brizendine EJ. Emergency physician-verified out-of-hospital intubation: miss rates by paramedics. Acad Emerg Med 2004;11:707–9.

16. Murdoch H, Cook T M. Effective ventilation during CPR via LMA-Supreme, Anaesthesia 2008;63:316-27.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time

Conferences

    Top