COMPARISON OF VARIOUS INTUBATION DEVICED DURING RESUSCITATION OF COVID-19-SUSPECTED PATIENTS BY PARAMEDICS WEARING PERSONAL PROTECTIVE EQUIPMENT

Background: Endotracheal intubation is one of the basic methods for airway control during cardiopulmonary resuscitation. In the era of the prevailing pandemic of SARS-CoV-2, medical personnel may face a necessity of resuscitating aninfected patient. Objective: The objective was to compare three int...

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Main Authors: Piechowski W., Smereka J., Drozd A., Dabrowski M., Sowizdraniuk J., Ladny J. R., Yakubtsevich R. E., Szarpak L.
Format: Article
Language:Belarusian
Published: Grodno State Medical University 2020-11-01
Series:Žurnal Grodnenskogo Gosudarstvennogo Medicinskogo Universiteta
Subjects:
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author Piechowski W.
Smereka J.
Drozd A.
Dabrowski M.
Sowizdraniuk J.
Ladny J. R.
Yakubtsevich R. E.
Szarpak L.
author_facet Piechowski W.
Smereka J.
Drozd A.
Dabrowski M.
Sowizdraniuk J.
Ladny J. R.
Yakubtsevich R. E.
Szarpak L.
author_sort Piechowski W.
collection DOAJ
description Background: Endotracheal intubation is one of the basic methods for airway control during cardiopulmonary resuscitation. In the era of the prevailing pandemic of SARS-CoV-2, medical personnel may face a necessity of resuscitating aninfected patient. Objective: The objective was to compare three intubation methods for suspected/confirmed COVID-19 adult patient resuscitation performed by paramedics wearing personal protective equipment (PPE) for aerosol generating procedures (AGP). Material and Methods: The multicentre, single-blind, prospective, randomized, crossover simulation trial involved 32 paramedics. The participants wearing PPE AGP performed tracheal intubations with the Macintosh, Airtraq, and McGrath MAC laryngoscopes in a patient with suspected COVID-19 in two resuscitation scenarios: scenario A – without chest compressions; scenario B – with continuous chest compressions. The primary outcome was time to intubation. Results: In scenario A, the intubation time for the respective devices equalled 35 s (IQR: 29–46) vs. 44s (IQR: 35–67) vs. 49 (IQR: 34–72) (p = 0.003). The total efficacy of each intubation method was 100%; however, the efficacy of the first intubation attempt was highest for McGrath MAC (90.6%), followed by Macintosh (68.1%) and Airtraq 62.5%) (p<0.001). In scenario B, the results with McGrath MAC were significantly better than those with Macintosh and Airtraq(p<0.05) for all the analysed variables. Conclusions: In conclusion, the McGrath MAC videolaryngoscope offers better intubation conditions as compared with the Macintosh laryngoscope or Airtraq in the resuscitation COVID-19.
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spelling doaj.art-321ad15ae249497fb4c7cba6c242395e2022-12-21T20:25:36ZbelGrodno State Medical UniversityŽurnal Grodnenskogo Gosudarstvennogo Medicinskogo Universiteta2221-87852413-01092020-11-01184382388http://dx.doi.org/10.25298/2221-8785-2020-18-4-382-388COMPARISON OF VARIOUS INTUBATION DEVICED DURING RESUSCITATION OF COVID-19-SUSPECTED PATIENTS BY PARAMEDICS WEARING PERSONAL PROTECTIVE EQUIPMENTPiechowski W.0https://orcid.org/0000-0001-8526-7983Smereka J.1https://orcid.org/0000-0002-1427-4796Drozd A.2https://orcid.org/0000-0003-1949-4023Dabrowski M.3https://orcid.org/0000-0003-2936-891XSowizdraniuk J.4https://orcid.org/0000-0002-6738-3080Ladny J. R.5https://orcid.org/0000-0003-4167-1962Yakubtsevich R. E.6https://orcid.org/0000-0002-8699-8216Szarpak L.7https://orcid.org/0000-0002-0973-5455Polish Society of Disaster Medicine, Warsaw, PolandWroclaw Medical University, Wroclaw, PolandPolish Society of Disaster Medicine, Warsaw, PolandPoznan University of Medical Sciences, Poznan, PolandWroclaw Medical University, Wroclaw, PolandMedical University of Bialystok, Bialystok, PolandGrodno State Medical University, Grodno, BelarusPolish Society of Disaster Medicine, Warsaw, PolandBackground: Endotracheal intubation is one of the basic methods for airway control during cardiopulmonary resuscitation. In the era of the prevailing pandemic of SARS-CoV-2, medical personnel may face a necessity of resuscitating aninfected patient. Objective: The objective was to compare three intubation methods for suspected/confirmed COVID-19 adult patient resuscitation performed by paramedics wearing personal protective equipment (PPE) for aerosol generating procedures (AGP). Material and Methods: The multicentre, single-blind, prospective, randomized, crossover simulation trial involved 32 paramedics. The participants wearing PPE AGP performed tracheal intubations with the Macintosh, Airtraq, and McGrath MAC laryngoscopes in a patient with suspected COVID-19 in two resuscitation scenarios: scenario A – without chest compressions; scenario B – with continuous chest compressions. The primary outcome was time to intubation. Results: In scenario A, the intubation time for the respective devices equalled 35 s (IQR: 29–46) vs. 44s (IQR: 35–67) vs. 49 (IQR: 34–72) (p = 0.003). The total efficacy of each intubation method was 100%; however, the efficacy of the first intubation attempt was highest for McGrath MAC (90.6%), followed by Macintosh (68.1%) and Airtraq 62.5%) (p<0.001). In scenario B, the results with McGrath MAC were significantly better than those with Macintosh and Airtraq(p<0.05) for all the analysed variables. Conclusions: In conclusion, the McGrath MAC videolaryngoscope offers better intubation conditions as compared with the Macintosh laryngoscope or Airtraq in the resuscitation COVID-19.endotracheal intubationpersonal protective equipmentcovid-19paramediccardiopulmonary resuscitation
spellingShingle Piechowski W.
Smereka J.
Drozd A.
Dabrowski M.
Sowizdraniuk J.
Ladny J. R.
Yakubtsevich R. E.
Szarpak L.
COMPARISON OF VARIOUS INTUBATION DEVICED DURING RESUSCITATION OF COVID-19-SUSPECTED PATIENTS BY PARAMEDICS WEARING PERSONAL PROTECTIVE EQUIPMENT
Žurnal Grodnenskogo Gosudarstvennogo Medicinskogo Universiteta
endotracheal intubation
personal protective equipment
covid-19
paramedic
cardiopulmonary resuscitation
title COMPARISON OF VARIOUS INTUBATION DEVICED DURING RESUSCITATION OF COVID-19-SUSPECTED PATIENTS BY PARAMEDICS WEARING PERSONAL PROTECTIVE EQUIPMENT
title_full COMPARISON OF VARIOUS INTUBATION DEVICED DURING RESUSCITATION OF COVID-19-SUSPECTED PATIENTS BY PARAMEDICS WEARING PERSONAL PROTECTIVE EQUIPMENT
title_fullStr COMPARISON OF VARIOUS INTUBATION DEVICED DURING RESUSCITATION OF COVID-19-SUSPECTED PATIENTS BY PARAMEDICS WEARING PERSONAL PROTECTIVE EQUIPMENT
title_full_unstemmed COMPARISON OF VARIOUS INTUBATION DEVICED DURING RESUSCITATION OF COVID-19-SUSPECTED PATIENTS BY PARAMEDICS WEARING PERSONAL PROTECTIVE EQUIPMENT
title_short COMPARISON OF VARIOUS INTUBATION DEVICED DURING RESUSCITATION OF COVID-19-SUSPECTED PATIENTS BY PARAMEDICS WEARING PERSONAL PROTECTIVE EQUIPMENT
title_sort comparison of various intubation deviced during resuscitation of covid 19 suspected patients by paramedics wearing personal protective equipment
topic endotracheal intubation
personal protective equipment
covid-19
paramedic
cardiopulmonary resuscitation
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