Comparison of a conventional tracheal airway with the Combitube in an urban emergency medical services system run by physicians
| Autor: | Thomas Staudinger, Rainer Thell, Bettina Eder, Roland Hofbauer, Viktor Dufek, Michael Frass, Werner Rabitsch, Harald Raab, Ernst Schuster, Peter Schellongowski |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male Emergency Medical Services medicine.medical_specialty medicine.medical_treatment Emergency Nursing Risk Assessment Sensitivity and Specificity Laryngeal Masks law.invention Reference Values law Intubation Intratracheal Urban Health Services Emergency medical services medicine Humans Intubation Prospective Studies Aged Probability Aged 80 and over business.industry Middle Aged respiratory system Intensive care unit Heart Arrest Surgery Survival Rate Treatment Outcome Combitube Austria Anesthesia Emergency Medicine Vomiting Female Airway management medicine.symptom Cardiology and Cardiovascular Medicine Airway business Follow-Up Studies |
| Zdroj: | Resuscitation. 57:27-32 |
| ISSN: | 0300-9572 |
| DOI: | 10.1016/s0300-9572(02)00435-5 |
| Popis: | This prospective randomised study was performed to compare the use of the Esophageal-Tracheal Combitube(R) (ETC; Tyco Healthcare, Mansfield, MA; http://www.combitube.org) with a conventional tracheal airway (ETA) for airway management by experienced physicians of the Emergency Medical Services System of the City of Vienna in the prehospital setting. Access to the patient's head, time of arrival of the ambulance, ease of insertion, time of insertion, potential substitution by the alternate airway, efficacy of adrenaline (epinephrine) administered via the airway, survival to the intensive care unit (ICU) ward and survival to discharge from the hospital were evaluated. One hundred and seventy-two non-traumatic cardiac arrest patients (131 males, 41 females) were enrolled in this study during a 12 months period. In 83 patients (48.3%), the conventional ETA (group 1) was used for the initial intubation attempt which was successful in 78 patients (94%). The remaining five patients of group 1 could not be intubated with an ETA, but were successfully managed with the ETC. Eighty-nine patients (51.7%) were intubated with the ETC (group 2) as first choice (79 in oesophageal position (89%); eight in tracheal position: (9%)), which was successful in 87 (98%) patients. The remaining two patients in group 2 (2%) were successfully managed with the ETA. Success of intubation and ventilation with ETC was comparable to the ETA. Recorded time of insertion was shorter with the ETC versus ETA (P0.05). The Combitube worked well in cases of difficult access to the patient's head and in bleeding and vomiting patients. Both devices served as successful substitutes for each other. Adrenaline (epinephrine) applied via ETC with a 10-fold dosage was as effective as via the conventional ETA. To our knowledge this is the first study using physicians comparing ETC and ETA in the prehospital setting. |
| Databáze: | OpenAIRE |
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