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Efficacy of double-lumen intubation performed by paramedics on patients with lung damage. Experimental, pilot simulation trial
, 2, 3, 4, 5
Affiliations- Department of Anesthesiology, Mazovian Specialist Hospital, Radom, Poland
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland.
- Lazarski University, Warsaw, Poland
- Departments of Outcomes Research and General Anesthesiology, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Department of Anaesthesiology and Intensive Care, Medical University of Silesia, Zabrze, Poland.
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Abstract
INTRODUCTION: 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.
MATERIAL AND 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 at 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
INTRODUCTION: 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.
MATERIAL AND 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 at 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.
Keywords
tracheal intubation; paramedic; one-lung ventilation; prehospital; medical simulation
About this articleTitle
Efficacy of double-lumen intubation performed by paramedics on patients with lung damage. Experimental, pilot simulation trial
Journal
Disaster and Emergency Medicine Journal
Issue
Article type
Research paper
Pages
7-11
Published online
2020-01-13
Page views
955
Article views/downloads
686
DOI
Bibliographic record
Disaster Emerg Med J 2020;5(1):7-11.
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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