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Published online: 2020-01-13
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Efficacy of double-lumen intubation performed by paramedics on patients with lung damage. Experimental, pilot simulation trial

Katarzyna Karczewska, Jacek Smereka, Lukasz Szarpak, Kurt Ruetzler, Szymon Bialka
DOI: 10.5603/DEMJ.a2020.0001

open access

Ahead of Print
ORIGINAL ARTICLES
Published online: 2020-01-13

Abstract

Background. The airway management and the implementation of optimal oxygen therapy in trauma patients, especially unconscious ones, is a key element of prehospital management. However, in cases of trauma lung or bronchial rupture, both lungs ventilation may not be advisable. In such cases, intubation with a double-lumen endotracheal tube may be helpful, allowing to provide one-lung ventilation. The aim of the experimental study was to assess the impact of short training in intubation using double-lumen tubes on the effectiveness of intubation performance and one-lung ventilation by paramedics in a simulated trauma patient setting. Methods. This was a prospective, observational, randomized experimental trial. The study involved 30 paramedics. The participants had to perform tracheal intubation using Double Lumen Tube VivaSight-DL (VS-DL; ETView Ltd.; Misgav, Israel) under normal airway conditions. The effectiveness of the first intubation attempt, the time of intubation and the Cormack-Lehane scale were evaluated. Results. The effectiveness of the first attempt of intubation with a double-lumen tube was 90% and the total effectiveness of intubation was 100%. The median time of the procedure was 63 (IQR; 38-72.5) seconds. Conclusions. In the simulation study, the paramedics were able to intubate using a double tube after a short training.

Abstract

Background. The airway management and the implementation of optimal oxygen therapy in trauma patients, especially unconscious ones, is a key element of prehospital management. However, in cases of trauma lung or bronchial rupture, both lungs ventilation may not be advisable. In such cases, intubation with a double-lumen endotracheal tube may be helpful, allowing to provide one-lung ventilation. The aim of the experimental study was to assess the impact of short training in intubation using double-lumen tubes on the effectiveness of intubation performance and one-lung ventilation by paramedics in a simulated trauma patient setting. Methods. This was a prospective, observational, randomized experimental trial. The study involved 30 paramedics. The participants had to perform tracheal intubation using Double Lumen Tube VivaSight-DL (VS-DL; ETView Ltd.; Misgav, Israel) under normal airway conditions. The effectiveness of the first intubation attempt, the time of intubation and the Cormack-Lehane scale were evaluated. Results. The effectiveness of the first attempt of intubation with a double-lumen tube was 90% and the total effectiveness of intubation was 100%. The median time of the procedure was 63 (IQR; 38-72.5) seconds. Conclusions. In the simulation study, the paramedics were able to intubate using a double tube after a short training.

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Keywords

tracheal intubation; paramedic; one lung ventilation; prehospital; medical simulation

About this article
Title

Efficacy of double-lumen intubation performed by paramedics on patients with lung damage. Experimental, pilot simulation trial

Journal

Disaster and Emergency Medicine Journal

Issue

Ahead of Print

Published online

2020-01-13

DOI

10.5603/DEMJ.a2020.0001

Keywords

tracheal intubation
paramedic
one lung ventilation
prehospital
medical simulation

Authors

Katarzyna Karczewska
Jacek Smereka
Lukasz Szarpak
Kurt Ruetzler
Szymon Bialka

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