Intubation during spinal motion restriction using the LuboTM cervical collar - a manikin simulation study
Introduction: The LuboTM collar is a cervical motion restriction device featuring a unique external jaw-thrust mechanism designed to provide non-invasive airway patency. In addition, tracheal intubation is facilitated by releasing an anterior chin strap; this allows better mouth opening than the pre...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-12-01
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| Series: | African Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211419X22000465 |
| _version_ | 1811221724127035392 |
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| author | Dinell Behari Rudhir Jaga Kobus Bergh Ross Hofmeyr |
| author_facet | Dinell Behari Rudhir Jaga Kobus Bergh Ross Hofmeyr |
| author_sort | Dinell Behari |
| collection | DOAJ |
| description | Introduction: The LuboTM collar is a cervical motion restriction device featuring a unique external jaw-thrust mechanism designed to provide non-invasive airway patency. In addition, tracheal intubation is facilitated by releasing an anterior chin strap; this allows better mouth opening than the previous generation of semi-rigid cervical collars. This study aimed to compare tracheal intubation using the LuboTM collar combined with manual in-line stabilization (MILS) to intubation with MILS alone. The primary outcome was the time to successful intubation. Secondary outcomes compared intubation success rate, Cormack-Lehane grade, ease of intubation and dental trauma. Methods: A randomized, cross-over, equivalence study was performed. Eighty full-time physician anaesthesia providers were recruited. Participants performed tracheal intubation using direct laryngoscopy on a manikin under two different scenarios: with the LuboTM collar and MILS applied, and with MILS and no cervical collar. The time to successful intubation was measured and compared using two-one-sided and paired t-tests. Results: Intubation times fell well within the a priori equivalence limits of 10 seconds, with a mean difference (95% CI) of 0.52 seconds (-1.30 to 2.56). There was no significant difference in intubation time with the LuboTM collar (mean [SD] 19.2 [4.5] seconds) compared to the MILS alone group (19.7 [5.2] seconds). The overall success rate was 98.7% in the Lubo group and 100% in the MILS group. Adequate laryngoscopy views (Cormack-Lehane grades I to IIb) were equivalent between groups (Lubo 92.5% versus MILS alone 93.7%). Conclusion: In this manikin-based study, the time to intubation with the LuboTM collar and MILS applied was equivalent to time to intubation with MILS alone, with similar intubating conditions. Thus, the LuboTM collar and MILS may simplify airway management by reducing the number of steps required to perform intubation in patients requiring cervical motion restriction. |
| first_indexed | 2024-04-12T08:05:39Z |
| format | Article |
| id | doaj.art-558316b0e23241328dbbf24bf182a203 |
| institution | Directory Open Access Journal |
| issn | 2211-419X |
| language | English |
| last_indexed | 2024-04-12T08:05:39Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | African Journal of Emergency Medicine |
| spelling | doaj.art-558316b0e23241328dbbf24bf182a2032022-12-22T03:41:11ZengElsevierAfrican Journal of Emergency Medicine2211-419X2022-12-01124327332Intubation during spinal motion restriction using the LuboTM cervical collar - a manikin simulation studyDinell Behari0Rudhir Jaga1Kobus Bergh2Ross Hofmeyr3Corresponding author.; Department of Anaesthesia & Perioperative Medicine, University of Cape Town, Cape Town, South AfricaDepartment of Anaesthesia & Perioperative Medicine, University of Cape Town, Cape Town, South AfricaDepartment of Anaesthesia & Perioperative Medicine, University of Cape Town, Cape Town, South AfricaDepartment of Anaesthesia & Perioperative Medicine, University of Cape Town, Cape Town, South AfricaIntroduction: The LuboTM collar is a cervical motion restriction device featuring a unique external jaw-thrust mechanism designed to provide non-invasive airway patency. In addition, tracheal intubation is facilitated by releasing an anterior chin strap; this allows better mouth opening than the previous generation of semi-rigid cervical collars. This study aimed to compare tracheal intubation using the LuboTM collar combined with manual in-line stabilization (MILS) to intubation with MILS alone. The primary outcome was the time to successful intubation. Secondary outcomes compared intubation success rate, Cormack-Lehane grade, ease of intubation and dental trauma. Methods: A randomized, cross-over, equivalence study was performed. Eighty full-time physician anaesthesia providers were recruited. Participants performed tracheal intubation using direct laryngoscopy on a manikin under two different scenarios: with the LuboTM collar and MILS applied, and with MILS and no cervical collar. The time to successful intubation was measured and compared using two-one-sided and paired t-tests. Results: Intubation times fell well within the a priori equivalence limits of 10 seconds, with a mean difference (95% CI) of 0.52 seconds (-1.30 to 2.56). There was no significant difference in intubation time with the LuboTM collar (mean [SD] 19.2 [4.5] seconds) compared to the MILS alone group (19.7 [5.2] seconds). The overall success rate was 98.7% in the Lubo group and 100% in the MILS group. Adequate laryngoscopy views (Cormack-Lehane grades I to IIb) were equivalent between groups (Lubo 92.5% versus MILS alone 93.7%). Conclusion: In this manikin-based study, the time to intubation with the LuboTM collar and MILS applied was equivalent to time to intubation with MILS alone, with similar intubating conditions. Thus, the LuboTM collar and MILS may simplify airway management by reducing the number of steps required to perform intubation in patients requiring cervical motion restriction.http://www.sciencedirect.com/science/article/pii/S2211419X22000465Airway managementIntubationCervical collarSpinal motion restrictionLubo |
| spellingShingle | Dinell Behari Rudhir Jaga Kobus Bergh Ross Hofmeyr Intubation during spinal motion restriction using the LuboTM cervical collar - a manikin simulation study African Journal of Emergency Medicine Airway management Intubation Cervical collar Spinal motion restriction Lubo |
| title | Intubation during spinal motion restriction using the LuboTM cervical collar - a manikin simulation study |
| title_full | Intubation during spinal motion restriction using the LuboTM cervical collar - a manikin simulation study |
| title_fullStr | Intubation during spinal motion restriction using the LuboTM cervical collar - a manikin simulation study |
| title_full_unstemmed | Intubation during spinal motion restriction using the LuboTM cervical collar - a manikin simulation study |
| title_short | Intubation during spinal motion restriction using the LuboTM cervical collar - a manikin simulation study |
| title_sort | intubation during spinal motion restriction using the lubotm cervical collar a manikin simulation study |
| topic | Airway management Intubation Cervical collar Spinal motion restriction Lubo |
| url | http://www.sciencedirect.com/science/article/pii/S2211419X22000465 |
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