open access

Ahead of Print
ORIGINAL ARTICLES
Published online: 2019-10-28
Get Citation

Successful one-lung ventilation using the VivaSight-EB bronchial blocker tube for an emergency lung injury. A simulation pilot data

Katarzyna Karczewska, Jacek Smereka, Lukasz Szarpak, Szymon Bialka
DOI: 10.5603/DEMJ.a2019.0025

open access

Ahead of Print
ORIGINAL ARTICLES
Published online: 2019-10-28

Abstract

Background. The ability to perform endotracheal intubation is one of the basic skills that paramedics should demonstrate. However, in some cases where lung or bronchial injuries have occurred, it may be necessary to separate the lung by attaching a bronchial blocker and ventilating single lung. Aim. The aim of the study was to evaluate the effectiveness of bronchial protection with VivaSight-EB bronchial blocker tube and one-lung ventilation by paramedics in conditions of simulated lung injury. Methods. The study was a prospective randomized cross-over simulation trial in which 27 paramedics took part. In the study, paramedics performed endotracheal intubation with ETView SL and then introduced a VivaSight-EB bronchial blocker and one-lung ventilation. The bronchial protection procedure took place in two scenarios: (A) normal airway; (B) difficult airway. VivaSight-EB bronchial blocker introduction time (T1) and one-lung ventilation time (T2) and the efficacy of the procedure were analysed. Results. The efficacy of endotracheal intubation with ETView SL tube was 100% during both Scenario A and Scenario B. The efficacy of endotracheal intubation with ETView SL tube was 100%. The effectiveness of the first attempt to protect the bronchi with a bronchial blocker was 26% for both scenarios and the total effectiveness of bronchial protection was 100% in both cases. Time T1 for endotracheal intubation was 18sec for Scenario A (IQR; 16.5 - 25) and 20 sec for Scenario B (IQR; 17 - 25). The time to perform one-lung ventilation (Time T2) in scenarios A and B was 43 sec (IQR; 38-62.5) vs. 43.5 sec (38-65). Conclusions. The simulation study confirmed the research hypothesis that the paramedics were able to perform one-lung ventilation using the ETView-Blocker® bronchial blocker tube after a short training.

Abstract

Background. The ability to perform endotracheal intubation is one of the basic skills that paramedics should demonstrate. However, in some cases where lung or bronchial injuries have occurred, it may be necessary to separate the lung by attaching a bronchial blocker and ventilating single lung. Aim. The aim of the study was to evaluate the effectiveness of bronchial protection with VivaSight-EB bronchial blocker tube and one-lung ventilation by paramedics in conditions of simulated lung injury. Methods. The study was a prospective randomized cross-over simulation trial in which 27 paramedics took part. In the study, paramedics performed endotracheal intubation with ETView SL and then introduced a VivaSight-EB bronchial blocker and one-lung ventilation. The bronchial protection procedure took place in two scenarios: (A) normal airway; (B) difficult airway. VivaSight-EB bronchial blocker introduction time (T1) and one-lung ventilation time (T2) and the efficacy of the procedure were analysed. Results. The efficacy of endotracheal intubation with ETView SL tube was 100% during both Scenario A and Scenario B. The efficacy of endotracheal intubation with ETView SL tube was 100%. The effectiveness of the first attempt to protect the bronchi with a bronchial blocker was 26% for both scenarios and the total effectiveness of bronchial protection was 100% in both cases. Time T1 for endotracheal intubation was 18sec for Scenario A (IQR; 16.5 - 25) and 20 sec for Scenario B (IQR; 17 - 25). The time to perform one-lung ventilation (Time T2) in scenarios A and B was 43 sec (IQR; 38-62.5) vs. 43.5 sec (38-65). Conclusions. The simulation study confirmed the research hypothesis that the paramedics were able to perform one-lung ventilation using the ETView-Blocker® bronchial blocker tube after a short training.

Get Citation

Keywords

one-lung ventilation; paramedic; airway management; emergency medicine; lung injury; bronchial blocker.

About this article
Title

Successful one-lung ventilation using the VivaSight-EB bronchial blocker tube for an emergency lung injury. A simulation pilot data

Journal

Disaster and Emergency Medicine Journal

Issue

Ahead of Print

Published online

2019-10-28

DOI

10.5603/DEMJ.a2019.0025

Keywords

one-lung ventilation
paramedic
airway management
emergency medicine
lung injury
bronchial blocker.

Authors

Katarzyna Karczewska
Jacek Smereka
Lukasz Szarpak
Szymon Bialka

References (26)
  1. Varga S, Shupp JW, Maher D, et al. Trauma airway management: transition from anesthesia to emergency medicine. J Emerg Med. 2013; 44(6): 1190–1195.
  2. Kosaka S. Tracheobronchial Injury. Kyobu Geka. 2015; 68(8): 660–664.
  3. Matthes G, Bernhard M, Kanz KG, et al. Emergency anesthesia, airway management and ventilation in major trauma. Background and key messages of the interdisciplinary S3 guidelines for major trauma patients. Anaesthesist. 2011; 60(11): 1027–1040.
  4. Mourisse Jo, Liesveld J, Verhagen Ad, et al. Efficiency, efficacy, and safety of EZ-blocker compared with left-sided double-lumen tube for one-lung ventilation. Anesthesiology. 2013; 118(3): 550–561.
  5. Moritz A, Irouschek A, Birkholz T, et al. The EZ-blocker for one-lung ventilation in patients undergoing thoracic surgery: clinical applications and experience in 100 cases in a routine clinical setting. J Cardiothorac Surg. 2018; 13(1): 77.
  6. Hoogenboom EM, Ong C, Christodoulides G. Placement of VivaSight(TM) double lumen tube. Anaesthesia. 2016; 71(6): 725–726.
  7. Loop T, Spaeth J. Airway Management in Thoracic Anesthesia with Double-Lumen Tube. Anasthesiol Intensivmed Notfallmed Schmerzther. 2018; 53(3): 174–185.
  8. Sawasdiwipachai P, Boonsri S, Suksompong S, et al. The uses of laryngeal mask airway ProSeal™ and endobronchial blocker for one lung anesthesia. J Anesth. 2015; 29(5): 660–665.
  9. Lim HK, Ahn HS, Byon HJ, et al. Clinical experience of one lung ventilation using an endobronchial blocker in a patient with permanent tracheostomy after total laryngectomy. Korean J Anesthesiol. 2013; 64(4): 386–387.
  10. Campos JH, Kernstine KH. A comparison of a left-sided Broncho-Cath with the torque control blocker univent and the wire-guided blocker. Anesth Analg. 2003; 96(1): 283–9, table of contents.
  11. Al Shehri AM, El-Tahan MR, Al Metwally R, et al. Right ventricular function during one-lung ventilation: effects of pressure-controlled and volume-controlled ventilation. J Cardiothorac Vasc Anesth. 2014; 28(4): 880–884.
  12. Pandharikar N, Sachdev A, Gupta N, et al. Chest trauma: A case for single lung ventilation. Indian J Crit Care Med. 2016; 20(4): 248–250.
  13. Kurowski A, Szarpak L, Truszewski Z, et al. Can the ETView VivaSight SL Rival Conventional Intubation Using the Macintosh Laryngoscope During Adult Resuscitation by Novice Physicians?: A Randomized Crossover Manikin Study. Medicine (Baltimore). 2015; 94(21): e850.
  14. Truszewski Z, Krajewski P, Fudalej M, et al. A comparison of a traditional endotracheal tube versus ETView SL in endotracheal intubation during different emergency conditions: A randomized, crossover cadaver trial. Medicine (Baltimore). 2016; 95(44): e5170.
  15. Markic S. Endotracheal tube ETView as a tool for airway management. Disaster and Emergency Medicine Journal. 2018; 3(4): 152–153.
  16. Glosser L. Assessment of endotracheal tube intubation. Review of existing scales. Disaster and Emergency Medicine Journal. 2017; 2(2): 91–93.
  17. Lockey DJ, Healey B, Crewdson K, et al. Advanced airway management is necessary in prehospital trauma patients. Br J Anaesth. 2015; 114(4): 657–662.
  18. Duchateau FX, Beardmore M, Gauss T, et al. Advanced prehospital airway management in patients with traumatic brain injury. Eur J Emerg Med. 2016; 23(5): 395.
  19. Jeong S, Ahn KiOk, Shin SDo. The role of prehospital advanced airway management on outcomes for out-of-hospital cardiac arrest patients: a meta-analysis. Am J Emerg Med. 2016; 34(11): 2101–2106.
  20. Gawlowski P, Smereka J, Madziala M, et al. Comparison of the ETView Single Lumen and Macintosh laryngoscopes for endotracheal intubation in an airway manikin with immobilized cervical spine by novice paramedics: A randomized crossover manikin trial. Medicine (Baltimore). 2017; 96(16): e5873.
  21. 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.
  22. Issenberg SB, McGaghie WC, Petrusa ER, et al. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach. 2005; 27(1): 10–28.
  23. Sawyer T, Gray MM. Procedural training and assessment of competency utilizing simulation. Semin Perinatol. 2016; 40(7): 438–446.
  24. Abelsson A. Learning through simulation. Disaster and Emergency Medicine Journal. 2017; 2(3): 125–128.
  25. Grensemann J, Eichler L, Hopf S, et al. Feasibility of an endotracheal tube-mounted camera for percutaneous dilatational tracheostomy. Acta Anaesthesiol Scand. 2017; 61(6): 660–667.
  26. Barak M, Assalia A, Mahajna A, et al. The use of VivaSight™ single lumen endotracheal tube in morbidly obese patients undergoing laparoscopic sleeve gastrectomy. BMC Anesthesiol. 2014; 14: 31.

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