Evaluation of tracheal intubation in several positions by the Pentax-AWS Airway Scope: a manikin study.
Summary of "Evaluation of tracheal intubation in several positions by the Pentax-AWS Airway Scope: a manikin study."
PURPOSE:
In emergency situations, rescuers must occasionally secure the airway while the patient is in a restricted position rather than in the ideal supine position. We hypothesized that the Pentax-AWS Airway Scope (AWS) may be useful for emergent tracheal intubation in such positions.
METHODS:
Thirteen non-anesthesia residents performed tracheal intubation on a simulated manikin in the supine (Supine), left-lateral decubitus (Left-LT), right-lateral decubitus (Right-LT), prone (Prone), and sitting (Sitting) position, respectively, to assess AWS performance.
RESULTS:
Intubations were successful in all five positions. The time needed to secure the airway did not differ significantly between the Left-LT and Supine positions. Doctors required significantly more time to secure the airway in the Prone, Sitting, and Right-LT positions than in the Supine position. Visual analog scale (VAS) scoring of the subjective difficulty of laryngoscopy was lower in the Supine position rather than in the Right-LT, Prone, and Sitting positions. The VAS score of subjective difficulty of tracheal tube passage through the glottis was significantly higher in the Sitting position than in the other four positions.
CONCLUSION:
Although tracheal intubations with AWS in all five positions tested were successful, intubation with the patient in the Sitting, Right-LT, and Prone positions was more difficult and required more time than that in the Supine position.
Affiliation
Department of Anesthesiology, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya, Hyogo, 663-8501, Japan, nkomazaw@hyo-med.ac.jp.
Journal Details
This article was published in the following journal.
Name: Journal of anesthesia
ISSN: 1438-8359
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20838819
- DOI: http://dx.doi.org/10.1007/s00540-010-1019-x
Medical and Biotech [MESH] Definitions
Airway Management
Evaluation, planning, and use of a range of procedures and airway devices for the maintenance or restoration of a patient's ventilation.
Laryngeal Masks
A type of oropharyngeal airway that provides an alternative to endotracheal intubation and standard mask anesthesia in certain patients. It is introduced into the hypopharynx to form a seal around the larynx thus permitting spontaneous or positive pressure ventilation without penetration of the larynx or esophagus. It is used in place of a facemask in routine anesthesia. The advantages over standard mask anesthesia are better airway control, minimal anesthetic gas leakage, a secure airway during patient transport to the recovery area, and minimal postoperative problems.
Asthma
A form of bronchial disorder with three distinct components: airway hyper-responsiveness (RESPIRATORY HYPERSENSITIVITY), airway INFLAMMATION, and intermittent AIRWAY OBSTRUCTION. It is characterized by spasmodic contraction of airway smooth muscle, WHEEZING, and dyspnea (DYSPNEA, PAROXYSMAL).
Personality Assessment
The determination and evaluation of personality attributes by interviews, observations, tests, or scales. Articles concerning personality measurement are considered to be within scope of this term.
Neuroendoscopes
Instruments for the visual examination of interior structures related to NEUROSURGICAL PROCEDURES. There are two broad categories of neuroendoscopes, the rigid scope and the flexible scope, for various types of procedures.
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