open access

Vol 2, No 4 (2017)
ORIGINAL ARTICLE
Published online: 2018-03-13
Get Citation

CAN THE FACE-TO-FACE INTUBATION TECHNIQUE BE USED DURING CARDIOPULMONARY RESUSCITATION? A PROSPECTIVE, RANDOMIZED, CROSSOVER MANIKIN TRIAL

Agnieszka Madziala, Togay Evrin, Wojciech Wieczorek, Halla Kaminska, Klaudiusz Nadolny, Jerzy Robert Ladny, Lukasz Szarpak
DOI: 10.5603/DEMJ.2017.0033
·
Disaster Emerg Med J 2017;2(4):145-149.

open access

Vol 2, No 4 (2017)
ORIGINAL ARTICLE
Published online: 2018-03-13

Abstract

 BACKGROUND: Endotracheal intubation in cardiopulmonary resuscitation conditions is the gold standard for the protection of airway patency, allowing for both ventilation with positive pressures and continuous moni­toring of carbon dioxide concentration in the exhaled air, as well as enabling continuous chest compressions.

AIM: The aim of the study was to compare the effectiveness of endotracheal intubation performed with the usage of Macintosh laryngoscope in two positions: behind the patient’s head and in the face-to-face position.

METHODS: We included 54 students during their final year of medicine in the study. All of participants declared the ability to perform endotracheal intubation based on direct laryngoscopy. Prior to the study, all participants took part in the training in laryngoscopy and cardiopulmonary resuscitation. During the study, the participants performed intubation in the simulated resuscitation environment in two scenarios: Scenario A — intubation from behind the patient;s head, Scenario B — face-to-face intubation. Participants had a maximum of three intubation attempts. The chest compressions were paused during the procedure.

RESULTS: The effectiveness of the first intubation attempt in the case of scenario A was 44.4%, while in the case of scenario B — 24.1%. The overall success ratios of intubation for scenarios A and B were 88.9% vs. 53.7%, respectively. The median intubation time during scenario A was 43.5 [IQR; 34–53.5] seconds, and 54.5 [IQR; 38.5–59.5] seconds for scenario B.

CONCLUSIONS: In the study, intubation performed by final-year medical students while taking a position behind the head of the victim was of a higher efficiency when compared to the face-to-face position.

Abstract

 BACKGROUND: Endotracheal intubation in cardiopulmonary resuscitation conditions is the gold standard for the protection of airway patency, allowing for both ventilation with positive pressures and continuous moni­toring of carbon dioxide concentration in the exhaled air, as well as enabling continuous chest compressions.

AIM: The aim of the study was to compare the effectiveness of endotracheal intubation performed with the usage of Macintosh laryngoscope in two positions: behind the patient’s head and in the face-to-face position.

METHODS: We included 54 students during their final year of medicine in the study. All of participants declared the ability to perform endotracheal intubation based on direct laryngoscopy. Prior to the study, all participants took part in the training in laryngoscopy and cardiopulmonary resuscitation. During the study, the participants performed intubation in the simulated resuscitation environment in two scenarios: Scenario A — intubation from behind the patient;s head, Scenario B — face-to-face intubation. Participants had a maximum of three intubation attempts. The chest compressions were paused during the procedure.

RESULTS: The effectiveness of the first intubation attempt in the case of scenario A was 44.4%, while in the case of scenario B — 24.1%. The overall success ratios of intubation for scenarios A and B were 88.9% vs. 53.7%, respectively. The median intubation time during scenario A was 43.5 [IQR; 34–53.5] seconds, and 54.5 [IQR; 38.5–59.5] seconds for scenario B.

CONCLUSIONS: In the study, intubation performed by final-year medical students while taking a position behind the head of the victim was of a higher efficiency when compared to the face-to-face position.

Get Citation

Keywords

endotracheal intubation, direct laryngoscopy, cardiopulmonary resuscitation, efficacy

About this article
Title

CAN THE FACE-TO-FACE INTUBATION TECHNIQUE BE USED DURING CARDIOPULMONARY RESUSCITATION? A PROSPECTIVE, RANDOMIZED, CROSSOVER MANIKIN TRIAL

Journal

Disaster and Emergency Medicine Journal

Issue

Vol 2, No 4 (2017)

Pages

145-149

Published online

2018-03-13

DOI

10.5603/DEMJ.2017.0033

Bibliographic record

Disaster Emerg Med J 2017;2(4):145-149.

Keywords

endotracheal intubation
direct laryngoscopy
cardiopulmonary resuscitation
efficacy

Authors

Agnieszka Madziala
Togay Evrin
Wojciech Wieczorek
Halla Kaminska
Klaudiusz Nadolny
Jerzy Robert Ladny
Lukasz Szarpak

References (23)
  1. McNally B, Robb R, Mehta M, et al. Centers for Disease Control and Prevention. Out-of-hospital cardiac arrest surveillance --- Cardiac Arrest Registry to Enhance Survival (CARES), United States, October 1, 2005--December 31, 2010. MMWR Surveill Summ. 2011; 60(8): 1–19.
  2. Blom MT, Beesems SG, Homma PCM, et al. Improved survival after out-of-hospital cardiac arrest and use of automated external defibrillators. Circulation. 2014; 130(21): 1868–1875.
  3. Porzer M, Mrazkova E, Homza M, et al. Out-of-hospital cardiac arrest. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2017; 161(4): 348–353.
  4. Gach D, Nowak JU, Krzych ŁJ. Epidemiology of out-of-hospital cardiac arrest in the Bielsko-Biala district: a 12-month analysis. Kardiol Pol. 2016; 74(10): 1180–1187.
  5. Pleskot M, Babu A, Hazukova R, et al. Characteristics and short-term survival of individuals with out-of-hospital cardiac arrests in the East Bohemian region. Resuscitation. 2006; 68(2): 209–220.
  6. Franek O, Pokorna M, Sukupova P. Pre-hospital cardiac arrest in Prague, Czech Republic--the Utstein-style report. Resuscitation. 2010; 81(7): 831–835.
  7. Berdowski J, Berg RA, Tijssen JGP, et al. Global incidences of out-of-hospital cardiac arrest and survival rates: Systematic review of 67 prospective studies. Resuscitation. 2010; 81(11): 1479–1487.
  8. Müller D, Agrawal R, Arntz HR. How sudden is sudden cardiac death? Circulation. 2006; 114(11): 1146–1150.
  9. Holmberg M, Holmberg S, Herlitz J, et al. Swedish Cardiac Arrest Registry. Survival after cardiac arrest outside hospital in Sweden. Swedish Cardiac Arrest Registry. Resuscitation. 1998; 36(1): 29–36.
  10. Bielski K, Szarpak L, Smereka J, et al. Comparison of four different intraosseous access devices during simulated pediatric resuscitation. A randomized crossover manikin trial. Eur J Pediatr. 2017; 176(7): 865–871.
  11. Smereka J, Szarpak L, Ladny JR. The LMA Fastrach® as a conduit for endotracheal intubation during simulated cardiopulmonary resuscitation. Am J Emerg Med. 2017; 35(7): 1020–1021.
  12. Szarpak L. Does VideoStylet improve the effectiveness of endotracheal intubation during cardiopulmonary resuscitation? Am J Emerg Med. 2017; 35(12): 1981–1982.
  13. Szarpak Ł, Truszewski Z, Gałązkowski R, et al. A randomized crossover trial comparing the C-MAC and Macintosh laryngoscopes for face-to-face intubation in a manikin. Am J Emerg Med. 2016; 34(5): 920–922.
  14. Hafner JW, Perkins BW, Korosac JD, et al. Difficult tracheal intubation in obstetrics. Anaesthesia. 1984; 39(11): 1105–1111.
  15. Jain D, Mehta S, Gandhi K, et al. Comparison of intubation conditions with CMAC Miller videolaryngoscope and conventional Miller laryngoscope in lateral position in infants: A prospective randomized trial. Paediatr Anaesth. 2018 [Epub ahead of print].
  16. April MD, Schauer SG, Brown Rd CA, et al. A 12-month descriptive analysis of emergency intubations at Brooke Army Medical Center: a National Emergency Airway Registry study. US Army Med Dep J. 2017(3-17): 98–104.
  17. Cavus E, Janssen S, Reifferscheid F, et al. Videolaryngoscopy for Physician-Based, Prehospital Emergency Intubation: A Prospective, Randomized, Multicenter Comparison of Different Blade Types Using A.P. Advance, C-MAC System, and KingVision. Anesth Analg. 2017 [Epub ahead of print].
  18. Madziala A, Majer J, Madziała M. Comparison of ETView SL, Airtraq, and Macintosh laryngoscopes for face-to-face tracheal intubation: a randomized crossover manikin trial. Am J Emerg Med. 2016; 34(9): 1893–1894.
  19. Arslan Zİ, Turna C, Gümüş NE, et al. Intubation of a Paediatric Manikin in Tongue Oedema and Face-to-Face Simulations by Novice Personnel: a Comparison of Glidescope, Airtraq and Direct Laryngoscopy. Turk J Anaesthesiol Reanim. 2016; 44(2): 71–75.
  20. Amathieu R, Sudrial J, Abdi W, et al. Simulating face-to-face tracheal intubation of a trapped patient: a randomized comparison of the LMA Fastrach™, the GlideScope™, and the Airtraq™ laryngoscope. Br J Anaesth. 2012; 108(1): 140–145.
  21. Szarpak Ł, Truszewski Z, Gałązkowski R, et al. A randomized crossover trial comparing the C-MAC and Macintosh laryngoscopes for face-to-face intubation in a manikin. Am J Emerg Med. 2016; 34(5): 920–922.
  22. Szarpak L, Truszewski Z, Czyzewski L, et al. A comparison of the McGrath-MAC and Macintosh laryngoscopes for child tracheal intubation during resuscitation by paramedics. A randomized, crossover, manikin study. Am J Emerg Med. 2016; 34(8): 1338–1341.
  23. Szarpak Ł, Karczewska K, Czyżewski Ł, et al. Airtraq Laryngoscope Versus the Conventional Macintosh Laryngoscope During Pediatric Intubation Performed by Nurses: A Randomized Crossover Manikin Study With Three Airway Scenarios. Pediatr Emerg Care. 2017; 33(11): 735–739.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl