EMT-led laryngeal tube vs. face-mask ventilation during cardiopulmonary resuscitation - a multicenter prospective randomized trial

Autor: Anna Fiala, Ernst Toferer, Peter Paal, Sabrina Neururer, Agnes Neumayr, Tamara Egger, Wolfgang Lederer, M. Baubin
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Laryngeal tube
Male
medicine.medical_specialty
Emergency Medical Services
medicine.medical_treatment
Airway management
030204 cardiovascular system & hematology
Critical Care and Intensive Care Medicine
Laryngeal Masks
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
medicine
Emergency medical services
Intubation
Intratracheal
Humans
Cardiopulmonary resuscitation
Prospective Studies
Aged
Original Research
Mask ventilation
business.industry
Prehospital emergency medicine
lcsh:Medical emergencies. Critical care. Intensive care. First aid
030208 emergency & critical care medicine
lcsh:RC86-88.9
Cardiac arrest
Respiration
Artificial
Surgery
Emergency Medical Technicians
Emergency medicine
Emergency Medicine
Breathing
Female
Airway
business
Out-of-Hospital Cardiac Arrest
Zdroj: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Vol 25, Iss 1, Pp 1-7 (2017)
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
ISSN: 1757-7241
Popis: Background Laryngeal tube (LT) application by rescue personnel as an alternate airway during the early stages of out-of-hospital cardiac arrest (OHCA) is still subject of debate. We evaluated ease of handling and efficacy of ventilation administered by emergency medical technicians (EMTs) using LT and bag-valve-mask (BVM) during cardiopulmonary resuscitation of patients with OHCA. Methods An open prospective randomized multicenter study was conducted at six emergency medical services centers over 18 months. Patients in OHCA initially resuscitated by EMTs were enrolled. Ease of handling (LT insertion, tight seal) and efficacy of ventilation (chest rises visibly, no air leak) with LT and BVM were subjectively assessed by EMTs during pre-study training and by the attending emergency physician on the scene. Outcome and frequency of complications were compared. Results Of 97 eligible patients, 78 were enrolled. During pre-study training EMTs rated efficacy of ventilation with LT higher than with BVM (66.7% vs. 36.2%, p = 0.022), but efficacy of on-site ventilation did not differ between the two groups (71.4% vs. 58.5%, p = 0.686). Frequency of complications (11.4% vs. 19.5%, p = 0.961) did not differ between the two groups. Conclusions EMTs preferred LT ventilation to BVM ventilation during pre-study training, but on-site there was no difference with regard to efficacy, ventilation safety, or outcome. The results indicate that LT ventilation by EMTs during OHCA is not superior to BVM and cannot substitute for BVM training. We assume that the main benefit of the LT is the provision of an alternative airway when BVM ventilation fails. Training in BVM ventilation remains paramount in EMT apprenticeship and cannot be substituted by LT ventilation. Trial registration ClinicalTrials.gov (NCT01718795). Electronic supplementary material The online version of this article (10.1186/s13049-017-0446-1) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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