Clin Exp Emerg Med.  2018 Mar;5(1):29-34. 10.15441/ceem.16.188.

Pre-hospital i-gel blind intubation for trauma: a simulation study

Affiliations
  • 1Department of Emergency Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea. drkang9@hanmail.net

Abstract


OBJECTIVE
This study aimed to evaluate the efficacy of i-gel blind intubation (IGI) as a rescue device for definitive airway management in ground intubation for pre-hospital trauma patients.
METHODS
A prospective randomized crossover study was conducted with 18 paramedics to examine intubation performance of two blind intubation techniques through a supraglottic airway devices (IGI and laryngeal mask airway Fastrach), compared with use of a Macintosh laryngoscope (MCL). Each intubation was conducted at two levels of patient positions (ground- and stretcher-level). Primary outcomes were the intubation time and the success rate for intubation.
RESULTS
The intubation time (sec) of each intubation technique was not significantly different between the two positions. In both patient positions, the intubation time of IGI was shortest among the three intubation techniques (17.9±5.2 at the ground-level and 16.9±3.8 at the stretcher-level). In the analysis of cumulative success rate and intubation time, IGI was the fastest to reach 100% success among the three intubation techniques regardless of patient position (all P < 0.017). The success of intubation was only affected by the intubation technique, and IGI achieved more success than MCL (odds ratio, 3.6; 95% confidence interval, 1.1 to 11.6; P=0.03).
CONCLUSION
The patient position did not affect intubation performance. Additionally, the intubation time with blind intubation through supraglottic airway devices, especially with IGI, was significantly shorter than that with MCL.

Keyword

Intubation; Airway management; Emergency medical technicians; Simulation training

MeSH Terms

Airway Management
Allied Health Personnel
Cross-Over Studies
Emergency Medical Technicians
Humans
Intubation*
Laryngeal Masks
Laryngoscopes
Prospective Studies
Simulation Training
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