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Feasibility and speed of insertion of seven supraglottic airway devices under simulated airway conditions

Published online by Cambridge University Press:  11 May 2015

Oliver Robak ,
Marco Leonardelli ,
Konstantin Zedtwitz-Liebenstein ,
Kurt Rützler ,
Ernst Schuster ,
Sonia Vaida ,
Ramez Salem  and
Michael Frass
Oliver Robak*
Affiliation:
Department of Medicine I, Medical University Vienna, Vienna, Austria
Marco Leonardelli
Affiliation:
Department of Medicine I, Medical University Vienna, Vienna, Austria
Konstantin Zedtwitz-Liebenstein
Affiliation:
Head Office of Vienna Hospital Association, Vienna, Austria
Kurt Rützler
Affiliation:
Department of Anesthesiology and General Intensive Care, Medical University Vienna, Vienna, Austria
Ernst Schuster
Affiliation:
Center for Medical Statistics, Informatics and Intelligent Systems, Medical University Vienna, Vienna, Austria
Sonia Vaida
Affiliation:
Department of Anesthesiology, Penn State Milton S. Hershey Medical Center, Hershey, PA
Ramez Salem
Affiliation:
Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL
*
Department of Medicine I, Intensive Care Unit, Medical University Vienna, Waehringer Guertel 18-20, A 1090 Vienna, Austria; [email protected].

Abstract

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Objectives:

Endotracheal intubation (ETI) is considered the gold standard for protecting the airway. Alternative devices for airway protection have been developed that can be used by untrained personnel, by those with less experience, and for when ETI is not possible. The main goals of our study were to evaluate the success rate and speed of insertion of different supraglottic airway devices and to determine whether the devices could be properly inserted under simulated critical conditions.

Methods:

Fifty medical students used an airway simulation trainer (Laerdal SimMan 3G) to assess the success rate and time used to insert seven different supraglottic airway devices under simulated physiologic and pathologic conditions in two different runs.

Results:

Although all airway devices could be inserted without problems, only the Combitube and the EasyTube could be successfully inserted in simulations of trismus, limited mobility of the cervical spine, or a combination of pathologic conditions such as trismus plus limited mobility of the spine and trismus plus tongue edema. The insertion time was significantly longer with LMA Unique, Fastrach, and I-Gel devices in both the first and second runs.

Conclusion:

The Combitube and the EasyTube were most easily inserted under simulated conditions such as trismus, limited mobility of the cervical spine, and combined pathologic conditions. Although all devices are useful for establishing an airway by nontrained medical students in standard simulations, we suggest that the Combitube and the EasyTube may offer advantages in difficult airway situations.

Keywords

emergency medicinemanikinsupraglottic airway
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 14 , Issue 6 , November 2012 , pp. 330 - 334
Copyright
Copyright © Canadian Association of Emergency Physicians 2012

References

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