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Eur J Emerg Med. 2014 Jun;21(3):189-94. doi: 10.1097/MEJ.0b013e32836033b3.

Bag-mask ventilation and direct laryngoscopy versus intubating laryngeal mask airway: a manikin study of hands-on times during cardiopulmonary resuscitation.

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1
aDepartment of Anaesthesiology, Emergency and Intensive Care Medicine, University Medical Centre bDepartment of Medical Statistics, University of Göttingen, Göttingen cDepartment of Anaesthesiology, University of Regensburg, Regensburg, Germany.

Abstract

OBJECTIVES:

The percentage of hands-on time during cardiopulmonary resuscitation is a major determinant of patient outcome. We hypothesized that airway management with the intubating laryngeal mask airway (ILMA) would give greater hands-on time than with bag-mask ventilation (BMV), followed by direct laryngoscopy (DL), particularly in difficult-to-manage airways.

PARTICIPANTS AND METHODS:

Thirty paramedics and 40 medical students performed four standardized, 6-min cardiopulmonary resuscitation scenarios with the SimMan3G in a random sequence. These were normal and difficult-to-manage airways using either BMV+DL or ILMA.

RESULTS:

The time to the first successful ventilation was significantly longer with the ILMA (P<0.001). Hands-on time was lower for the ILMA after 2 min (67±8 vs. 81±8 s for BMV+DL, P<0.001), but was then significantly greater from the third minute onward (115±11 vs. 104±9 s for BMV+DL, P<0.001). The success rate of the first intubation attempt was higher and the time to ET placement was shorter with the ILMA, especially in the difficult-to-manage airway (P<0.001).

CONCLUSION:

In this manikin-based study, hands-on time was greater with the ILMA than with BMV+DL. The ILMA was particularly useful in increasing hands-on times in the difficult-to-manage airway.

PMID:
23502213
DOI:
10.1097/MEJ.0b013e32836033b3
[Indexed for MEDLINE]
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