Success Rate on Endotracheal Intubation with Prone versus Kneeling Position in Mannequin Model with Limitation of Neck Movement: A Cross Over Study
Panvilai Tangkulpanich, Chetsadakon Jenpanitpong, Jirayoot Patchkrua, Chappawit Silarak, Nattagit Srinaowech, Natthaphong Thiamdao, Chaiyaporn Yuksen Department of Emergency Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Chetsadakon Jenpanitp...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2022-04-01
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| Series: | Open Access Emergency Medicine |
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| Online Access: | https://www.dovepress.com/success-rate-on-endotracheal-intubation-with-prone-versus-kneeling-pos-peer-reviewed-fulltext-article-OAEM |
| _version_ | 1818115878952108032 |
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| author | Tangkulpanich P Jenpanitpong C Patchkrua J Silarak C Srinaowech N Thiamdao N Yuksen C |
| author_facet | Tangkulpanich P Jenpanitpong C Patchkrua J Silarak C Srinaowech N Thiamdao N Yuksen C |
| author_sort | Tangkulpanich P |
| collection | DOAJ |
| description | Panvilai Tangkulpanich, Chetsadakon Jenpanitpong, Jirayoot Patchkrua, Chappawit Silarak, Nattagit Srinaowech, Natthaphong Thiamdao, Chaiyaporn Yuksen Department of Emergency Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Chetsadakon Jenpanitpong, Department of Emergency Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Thung Phayathai, Ratchathewi, Bangkok, 10400, Thailand, Tel +66 8 3183 1373, Fax +66 2201 2404, Email chetsadakon.jen@mahidol.ac.thPurpose: Endotracheal intubation is a lifesaving procedure for airway management but is more complex when performed in patients lying on the ground and requiring cervical spine immobilization. This study aims to compare the optimal technique between prone and kneeling positions in increasing intubation success rate on these prehospital trauma patients.Patients and Methods: This study was an experimental study on a mannequin. Paramedic students performed intubation on the supine mannequin, which was applied with a rigid cervical collar and manual in-line stabilization. The participants were randomly assigned to intubate in a prone or kneeling position as the first method, then perform another method seven days later. Study outcomes include the percentage of successful intubation, time to perform intubation successfully, and Cormack and Lehane’s classification of laryngeal view.Results: Thirty-nine participants were enrolled in this study; 22 were male (56.41%). The mean age, weight, and height were 23.15 ± 4.75 years, 67.38 ± 17.39 kg, and 167.36 ± 8.70 cm., respectively. The percentage of successful intubation in prone (37 [94.90%]) was higher than kneeling position (35 [89.74%]), but there was no statistically significant (p-value = 0.675). Time to intubation successfully, the number of attempts, and Cormack & Lehane’s laryngeal view classification were not significantly different between prone and kneeling groups (p-value = 0.808, 0.814, and 0.948, respectively).Conclusion: Intubation with the prone or kneeling position on a mannequin, lying on the ground with cervical spine immobilization, has no statistical difference. Both intubation approaches appear to be effective in successful and rapid intubation, proper glottic visualization and low attempts.Keywords: endotracheal intubation, airway management, prone position, kneeling position, advanced trauma life support care |
| first_indexed | 2024-12-11T04:13:37Z |
| format | Article |
| id | doaj.art-7a8720724d9d4b049f708f4e54e0ee48 |
| institution | Directory Open Access Journal |
| issn | 1179-1500 |
| language | English |
| last_indexed | 2024-12-11T04:13:37Z |
| publishDate | 2022-04-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Open Access Emergency Medicine |
| spelling | doaj.art-7a8720724d9d4b049f708f4e54e0ee482022-12-22T01:21:19ZengDove Medical PressOpen Access Emergency Medicine1179-15002022-04-01Volume 1417718274585Success Rate on Endotracheal Intubation with Prone versus Kneeling Position in Mannequin Model with Limitation of Neck Movement: A Cross Over StudyTangkulpanich PJenpanitpong CPatchkrua JSilarak CSrinaowech NThiamdao NYuksen CPanvilai Tangkulpanich, Chetsadakon Jenpanitpong, Jirayoot Patchkrua, Chappawit Silarak, Nattagit Srinaowech, Natthaphong Thiamdao, Chaiyaporn Yuksen Department of Emergency Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Chetsadakon Jenpanitpong, Department of Emergency Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Thung Phayathai, Ratchathewi, Bangkok, 10400, Thailand, Tel +66 8 3183 1373, Fax +66 2201 2404, Email chetsadakon.jen@mahidol.ac.thPurpose: Endotracheal intubation is a lifesaving procedure for airway management but is more complex when performed in patients lying on the ground and requiring cervical spine immobilization. This study aims to compare the optimal technique between prone and kneeling positions in increasing intubation success rate on these prehospital trauma patients.Patients and Methods: This study was an experimental study on a mannequin. Paramedic students performed intubation on the supine mannequin, which was applied with a rigid cervical collar and manual in-line stabilization. The participants were randomly assigned to intubate in a prone or kneeling position as the first method, then perform another method seven days later. Study outcomes include the percentage of successful intubation, time to perform intubation successfully, and Cormack and Lehane’s classification of laryngeal view.Results: Thirty-nine participants were enrolled in this study; 22 were male (56.41%). The mean age, weight, and height were 23.15 ± 4.75 years, 67.38 ± 17.39 kg, and 167.36 ± 8.70 cm., respectively. The percentage of successful intubation in prone (37 [94.90%]) was higher than kneeling position (35 [89.74%]), but there was no statistically significant (p-value = 0.675). Time to intubation successfully, the number of attempts, and Cormack & Lehane’s laryngeal view classification were not significantly different between prone and kneeling groups (p-value = 0.808, 0.814, and 0.948, respectively).Conclusion: Intubation with the prone or kneeling position on a mannequin, lying on the ground with cervical spine immobilization, has no statistical difference. Both intubation approaches appear to be effective in successful and rapid intubation, proper glottic visualization and low attempts.Keywords: endotracheal intubation, airway management, prone position, kneeling position, advanced trauma life support carehttps://www.dovepress.com/success-rate-on-endotracheal-intubation-with-prone-versus-kneeling-pos-peer-reviewed-fulltext-article-OAEMendotracheal intubationairway managementprone positionkneeling positionadvanced trauma life support care |
| spellingShingle | Tangkulpanich P Jenpanitpong C Patchkrua J Silarak C Srinaowech N Thiamdao N Yuksen C Success Rate on Endotracheal Intubation with Prone versus Kneeling Position in Mannequin Model with Limitation of Neck Movement: A Cross Over Study Open Access Emergency Medicine endotracheal intubation airway management prone position kneeling position advanced trauma life support care |
| title | Success Rate on Endotracheal Intubation with Prone versus Kneeling Position in Mannequin Model with Limitation of Neck Movement: A Cross Over Study |
| title_full | Success Rate on Endotracheal Intubation with Prone versus Kneeling Position in Mannequin Model with Limitation of Neck Movement: A Cross Over Study |
| title_fullStr | Success Rate on Endotracheal Intubation with Prone versus Kneeling Position in Mannequin Model with Limitation of Neck Movement: A Cross Over Study |
| title_full_unstemmed | Success Rate on Endotracheal Intubation with Prone versus Kneeling Position in Mannequin Model with Limitation of Neck Movement: A Cross Over Study |
| title_short | Success Rate on Endotracheal Intubation with Prone versus Kneeling Position in Mannequin Model with Limitation of Neck Movement: A Cross Over Study |
| title_sort | success rate on endotracheal intubation with prone versus kneeling position in mannequin model with limitation of neck movement a cross over study |
| topic | endotracheal intubation airway management prone position kneeling position advanced trauma life support care |
| url | https://www.dovepress.com/success-rate-on-endotracheal-intubation-with-prone-versus-kneeling-pos-peer-reviewed-fulltext-article-OAEM |
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