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

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

Christoph Stradtmann

Doctoral thesis

Date of Examination: 2018-03-28

Date of issue: 2018-03-27

Advisor: Russo, Sebastian G. PD Dr.

Referee: Schroeter, Marco PD Dr.

Referee: Schön, Margarete Prof. Dr.

Persistent Address: http://hdl.handle.net/11858/00-1735-0000-002E-E3A4-A

Files in this item

Name: Diss 21.03.2018 C.Stradtmann - finale Version zur Abgabe SUB inkl. Prüfernamen_weboptimiert.pdf

Size: 1,0 MB

Format: PDF

View/Open

The following license files are associated with this item:

Creative Commons

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