Semiprone position is superior to supine position for paediatric endotracheal intubation during massive regurgitation, a randomized crossover simulation trial
Abstract Background Endotracheal intubation of patients with massive regurgitation represents a challenge in emergency airway management. Gastric contents tend to block suction catheters, and few treatment alternatives exist. Based on a technique that was successfully applied in our district, we wan...
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| Format: | Article |
| Language: | English |
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BMC
2018-01-01
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| Series: | BMC Anesthesiology |
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| Online Access: | http://link.springer.com/article/10.1186/s12871-018-0474-z |
| _version_ | 1818341533647110144 |
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| author | Espen Fevang Karin Haaland Jo Røislien Conrad Arnfinn Bjørshol |
| author_facet | Espen Fevang Karin Haaland Jo Røislien Conrad Arnfinn Bjørshol |
| author_sort | Espen Fevang |
| collection | DOAJ |
| description | Abstract Background Endotracheal intubation of patients with massive regurgitation represents a challenge in emergency airway management. Gastric contents tend to block suction catheters, and few treatment alternatives exist. Based on a technique that was successfully applied in our district, we wanted to examine if endotracheal intubation would be easier and quicker to perform when the patient is turned over to a semiprone position, as compared to the supine position. Methods In a randomized crossover simulation trial, a child manikin with on-going regurgitation was intubated both in the supine and semiprone positions. Endpoints were experienced difficulty with the procedure and time to intubation, as well as visually confirmed intubation and first-pass success rate. Results Intubation in the semiprone position was significantly easier and faster compared to the supine position; the median experienced difficulty on a visual analogue scale was 27 and 65, respectively (p = 0.004), and the median time to intubation was 26 and 45 s, respectively (p = 0.001). There were no significant differences in frequency of visually confirmed intubation (16 and 18, p = 0.490) of first-pass success rate (17 and 18, p = 1.000). Conclusion In this experiment, endotracheal intubation during massive regurgitation with the patient in the semiprone position was significantly easier and quicker to perform than in the supine position. Endotracheal intubation in the semiprone position can provide a quick rescue method in situations where airway management is hindered by massive regurgitation, and it represents a possible supplement to current airway management training. |
| first_indexed | 2024-12-13T16:00:19Z |
| format | Article |
| id | doaj.art-7715bef52a5e4008a6b36a08fb70d6d6 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-13T16:00:19Z |
| publishDate | 2018-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-7715bef52a5e4008a6b36a08fb70d6d62022-12-21T23:39:11ZengBMCBMC Anesthesiology1471-22532018-01-011811710.1186/s12871-018-0474-zSemiprone position is superior to supine position for paediatric endotracheal intubation during massive regurgitation, a randomized crossover simulation trialEspen Fevang0Karin Haaland1Jo Røislien2Conrad Arnfinn Bjørshol3Department of Research and Development, Norwegian Air Ambulance FoundationDepartment of Health Studies, University of StavangerDepartment of Health Studies, University of StavangerDepartment of Anesthesiology and Intensive Care, Stavanger University HospitalAbstract Background Endotracheal intubation of patients with massive regurgitation represents a challenge in emergency airway management. Gastric contents tend to block suction catheters, and few treatment alternatives exist. Based on a technique that was successfully applied in our district, we wanted to examine if endotracheal intubation would be easier and quicker to perform when the patient is turned over to a semiprone position, as compared to the supine position. Methods In a randomized crossover simulation trial, a child manikin with on-going regurgitation was intubated both in the supine and semiprone positions. Endpoints were experienced difficulty with the procedure and time to intubation, as well as visually confirmed intubation and first-pass success rate. Results Intubation in the semiprone position was significantly easier and faster compared to the supine position; the median experienced difficulty on a visual analogue scale was 27 and 65, respectively (p = 0.004), and the median time to intubation was 26 and 45 s, respectively (p = 0.001). There were no significant differences in frequency of visually confirmed intubation (16 and 18, p = 0.490) of first-pass success rate (17 and 18, p = 1.000). Conclusion In this experiment, endotracheal intubation during massive regurgitation with the patient in the semiprone position was significantly easier and quicker to perform than in the supine position. Endotracheal intubation in the semiprone position can provide a quick rescue method in situations where airway management is hindered by massive regurgitation, and it represents a possible supplement to current airway management training.http://link.springer.com/article/10.1186/s12871-018-0474-zAirway managementIntubation, IntratrachealEmergency medical services |
| spellingShingle | Espen Fevang Karin Haaland Jo Røislien Conrad Arnfinn Bjørshol Semiprone position is superior to supine position for paediatric endotracheal intubation during massive regurgitation, a randomized crossover simulation trial BMC Anesthesiology Airway management Intubation, Intratracheal Emergency medical services |
| title | Semiprone position is superior to supine position for paediatric endotracheal intubation during massive regurgitation, a randomized crossover simulation trial |
| title_full | Semiprone position is superior to supine position for paediatric endotracheal intubation during massive regurgitation, a randomized crossover simulation trial |
| title_fullStr | Semiprone position is superior to supine position for paediatric endotracheal intubation during massive regurgitation, a randomized crossover simulation trial |
| title_full_unstemmed | Semiprone position is superior to supine position for paediatric endotracheal intubation during massive regurgitation, a randomized crossover simulation trial |
| title_short | Semiprone position is superior to supine position for paediatric endotracheal intubation during massive regurgitation, a randomized crossover simulation trial |
| title_sort | semiprone position is superior to supine position for paediatric endotracheal intubation during massive regurgitation a randomized crossover simulation trial |
| topic | Airway management Intubation, Intratracheal Emergency medical services |
| url | http://link.springer.com/article/10.1186/s12871-018-0474-z |
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