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The necessity for education on endotracheal intubation through video laryngoscope - A focused on paramedic students -

비디오 후두경을 통한 기관내 삽관 교육의 필요성 - 응급구조과 학생을 중심으로 -

  • Ham, Young-Lim (Department of Nursing, Daewon University) ;
  • Kim, Jin-Hwa (Department of Emergency Medical Technology, Daewon University, Kangwon National University Graduate School) ;
  • Lee, Jae-Gook (Department of Emergency Medical Services, Sunmoon University)
  • 함영림 (대원대학교 간호학과) ;
  • 김진화 (대원대학교 응급구조과, 강원대학교 일반대학원 응급구조학과) ;
  • 이재국 (선문대학교 응급구조학과)
  • Received : 2019.03.14
  • Accepted : 2019.04.14
  • Published : 2019.04.30

Abstract

Purpose: The aim of this study was to verify the necessity of endotracheal intubation through video laryngoscope and to provide basic data to inform the provision of video laryngoscope education. Methods: Eighty paramedic students participated in this study. A survey was conducted from November 5, 2018 to December 7, 2018. Data were analyzed with independent t-tests, and the chi-squared test. Results: The video laryngoscope is a highly usable instrument that can easily be applied during training. The instrument provides better visual evaluation of the normal airway (p=.004), the airway in case of cervical collar and head fixation (p=.000), and the airway in case of tongue edema (p=.000). The time of endotracheal intubation in the normal airway was significantly less with the video laryngoscope compared with the direct laryngoscope. The success rate of tracheal intubation was significantly higher in the video laryngoscope group than in the direct laryngoscope. Conclusion: This study suggests the necessity of education on endotracheal intubation through video laryngoscope in the professional airway maintenance training course of emergency department students. The video laryngoscope is easier to apply than the direct laryngoscope in cases of intubation in various clinical situations.

Keywords

Laryngoscope;Intubation;Paramedics;Students

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Fig.1. Cormack and Lehane classification of laryngoscopic views.

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Fig. 2. Visual evaluation according to laryngoscope type.

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Fig. 3. Intubation time according to laryngoscope type.

Table 1. Characteristics of the participants and usability of video laryngoscope

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Table 2. Visual evaluation and intubation time according to laryngoscope type

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Table 3. Intubation accuracy according to laryngoscope type

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References

  1. Kim BC, Kang BS, Song HG, Lee JH, Song KJ, Jeong YK. Endotracheal intubation in the emergency department of an tertiary care center. J Korean Soc Emerg Med 1999;10:579-86.
  2. Brandt L. The first reported oral intubation of human trachea. Anesth Analg 1987;66(11):1198-9.
  3. Jacobs LM, Berrizbeitia LD, Bennett B, Madigan C. Endotracheal intubation in the prehospital phase of emergency medical care. JAMA 1983;250(16):2175-7. https://doi.org/10.1001/jama.1983.03340160061033 https://doi.org/10.1001/jama.1983.03340160061033
  4. National Emergency Medical Center. Development of airway maintenance and breathing specialization curriculum(Research) 2007. 247.
  5. Jun YK, Jo SI, Jeong TO, Jin YH, Lee JB, Yoon JC et al. Evaluation of pre-hospital care provided by 119 rescuers in out-of-hospital cardiac arrests transported to tertiary emergency department covering a rural area. J Korean Soc Emerg Med 2011;22(5):391-9.
  6. Kim JH, Cho JS, Lim YS, Lee SB, Hyun SY, Kim JJ et al. The current state of airway management and ventilation at the pre-hospital stage by emergency medical technicians. J Korean Soc Emerg Med 2011;22(2):129-41.
  7. Brown III CA, Bair AE, Pallin DJ, Walls RM. Techniques, success, and adverse events of emergency department adult intubations. Ann Emerg Med 2015;65(4):363-70. https://doi.org/10.1016/j.annemergmed.2014.10.036 https://doi.org/10.1016/j.annemergmed.2014.10.036
  8. Kang GH. Development and evaluation of a self-efficacy-based life support program for high-risk patients' family caregivers. Unpublished doctoral dissertation, Seoul National University 2004, Seoul, Korea.
  9. Yun HW, Yu EY, Yun YH, Comparison of educational effects of difficult endotracheal intubation in the 119 rescue service. Journal of the Korea Contents Association 2011;11(1):254-65. https://doi.org/10.5392/JKCA.2011.11.1.254 https://doi.org/10.5392/JKCA.2011.11.1.254
  10. Nouruzi-Sedeh P, Schumann M, Groeben H. Laryngoscopy via Macintosh blade versus GlideScope: success rate and time for endotracheal intubation in untrained medical personnel. Anesthesiology 2009;110:32-7. https://doi.org/10.1097/ALN.0b013e318190b6a7 https://doi.org/10.1097/ALN.0b013e318190b6a7
  11. Kovacs, G, Law JA, McCrossin C, Vu M, Leblanc D, Gao J. A comparison of a fiberoptic stylet and a bougie as adjuncts to direct laryngoscopy in a manikin simulated difficult airway. Ann Emerg Med 2007;50(6):676-85. https://doi.org/10.1016/j.annemergmed.2007.05.022 https://doi.org/10.1016/j.annemergmed.2007.05.022
  12. Cooper RM, Pacey JA, Bishop MJ. McCluskey SA. Early clinical experience with a new videolaryngoscope($GlideScope^{(R)}$) in 728 patients. Can J Anaesth 2005;52(2):191-8. PMID: 15684262 https://doi.org/10.1007/BF03027728
  13. Robitaille A, Williams SR, Tremblay MH, Guilbert F, Theriault M, Drolet, P. Cervical spine motion during tracheal intubation with manual in-line stabilization: direct laryngoscopy versus $GlideScope^{(R)}$ videolaryngoscopy. Anesth Analg 2008;106(3):935-41. https://doi.org/10.1213/ane.0b013e318161769e https://doi.org/10.1213/ane.0b013e318161769e
  14. Narang A, Oldeg P, Medzon R, Mahmood A, Spector J, Robinett D. Comparison of intubation success of video laryngoscopy versus direct laryngoscopy in the difficult airway using high-fidelity simulation. Simul Health 2009;4(3):160-5. https://doi.org/10.1097/SIH.0b013e318197d2e5 https://doi.org/10.1097/SIH.0b013e318197d2e5
  15. Shin KS. Assessment on proficiency and usability of direst laryngoscopy and video laryngoscopy. Unpublished master's thesis, Korea National University of Transportation 2018, Jeungpyeong-gun, Korea.
  16. Lee WJ. Clinical usefulness of attachable video laryngoscope to conventional laryngoscope in difficult airway : a manikin study. Unpublished master's thesis, Yonsei University 2012, Seoul, Korea.
  17. Sim GS. Comparison of video laryngoscope and direct laryngoscope on rapidity and accuracy in tracheal intubation by paramedic. J Korean Soc Emerg Med Tech 2010;14(1):5-18.
  18. Choo HJ, Kwon OY, Ko YG. Educational suitability of endotracheal intubation using a video-laryngoscope. Korean Journal of Medical Education 2015;27(4):267-74. https://doi.org/10.3946/kjme.2015.27.4.267 https://doi.org/10.3946/kjme.2015.27.4.267
  19. Si JW, Lee SB, Do BS. Comparison of the Macintosh laryngoscope and the GlideScope (R) Video laryngoscope in easy and simulated difficult airway scenarios-A manikin study-. J Korean Soc Emerg Med 2009;20(6):604-8.
  20. Choi UJ, Cho KJ. A comparison of Endotracheal intubation using the Macintosh laryngoscope, the gum elastic bougie and the Pentax AirWay Scope in neck-stabilized manikin. J Korean Soc Emerg Med Tech 2011;15(3)71-80.
  21. Low D, Healy D, Rasburn N. The use of the BERCI DCI video laryngoscope for teaching novices direct laryngoscopy and tracheal intubation. Anesthesia 2008;63(2):195-201. https://doi.org/10.1111/j.1365-2044.2007.05323.x https://doi.org/10.1111/j.1365-2044.2007.05323.x
  22. Su YC, Chen CC, Lee YK, Lee JY, Lin KJ. Comparison of video laryngoscopes with direct laryngoscopy for tracheal intubation: a meta-analysis of randomized trials. Eur J Anaesthesiol 2011;28(11):788-95. https://doi.org/10.1097/EJA.0b013e32834a34f3 https://doi.org/10.1097/EJA.0b013e32834a34f3