Der Einfluss des Atemwegsmanagement unter Reanimationsbedingungen auf die Hands-on-Zeit: Ein Vergleich der Beutel-Masken-Ventilation und direkten Laryngoskopie mit der Intubationslarynxmaske

The influence of airway management under resuscitation conditions on hands-on time: a comparison of bag-mask ventilation and direct laryngoscopy with the intubation laryngeal mask

by Christoph Stradtmann
Doctoral thesis
Date of Examination:2018-03-28
Date of issue:2018-03-27
Advisor:PD Dr. Sebastian G. Russo
Referee:PD Dr. Marco Schroeter
Referee:Prof. Dr. Margarete Schön
Persistent Address: http://dx.doi.org/10.53846/goediss-6802

 

 

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Abstract

English

Objectives: In this study we compared two ventilation and intubation strategies with regard to their effect on hands-on time: ventilation and intubation with the intubating laryngeal mask airway (ILMA),versus bag mask ventilation (BMV) with tracheal intubation using direct laryngoscopy (DL). Methods: Thirty paramedics and 40 medical students were recruited to perform four standardized CPR manikin scenarios of six minutes each in a random sequence: normal to manage airways using either BMV + DL or the ILMA and difficult to manage airways, again using either BMV + DL or the ILMA. Results The scenarios of 25 paramedics and 36 students were analysed. The time to the first successful ventilation was significantly longer with the ILMA (p < 0.001). Hands-on time was initially lower for the ILMA (p < 0.001), but recovered within the first two minutes and was then significantly greater from minute 3 onward (p < 0.001). First success rate for intubation was higher and the time to ET placement was faster with the ILMA, especially in difficult-to-manage airways (p < 0.001). For difficult-to-manage airways, male participants had a significantly greater hands-on time using BMV + DL, whereas with the ILMA no difference was found between male and female participants. Conclusion: In this manikin-based study, the hands-on time was greater with the ILMA than with BMV + DL. In this setting, the ILMA was particularly useful for ventilation and intubation in difficult-to-manage airways and when used by female participants.
Keywords: resuscitation, intubating laryngeal mask airway, hands-on time, external chest compression, manikin, difficult airway
 
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