보건의료생명과학 논문지 (Journal of the Health Care and Life Science)

한국의료정보교육협회 (The Korean Society of Medical Informatics Education)
권호 표지
DOI QR코드

DOI QR Code

흡입기가 장착된 변형 후두경을 이용한 기관내 삽관의 유효성

Efficacy of Endotracheal Intubation Using a Modified Laryngoscope Equipped with an Aspirator

  • 윤종근 (호남대학교 응급구조학과)
  • Jong-Geun Yun (Department of Emergency Medical Service, Honam University)
  • 투고 : 2023.09.01
  • 심사 : 2023.10.05
  • 발행 : 2023.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

본 연구는 입 안에 이물질이 있는 경우 좀 더 신속하게 제거하고 기관내 삽관을 시행할 수 있는 후두경을 개발하고 이에 대한 유용성을 확인하고자 한다. 목적에 맞는 후두경을 제작하고, H 대학 4학년 30명을 대상으로 시행하였다. 실험방법은 이물질이 없는 경우, 이물질이 있는 경우 후두경 삽입 후 입 안흡입, 기관내 삽관 실시의 방법과 흡입기가 부착된 후두경을 사용하여 기관내 삽관을 시행하였다. 이물질이 있는 경우 기존방식과 개발된 일체형 후두경을 사용하여 흡입한 결과 일체형 후두경을 사용한 경우가 기존방식보다 흡입 시간이 단축되며, 통계적으로 유의한 차이가 나타났다(p< .000). 기관내 삽관에 소요되는 시간의 경우 일체형 후두경을 사용한 경우가 기존방식보다 기관내 삽관 시 소요되는 시간이 단축되며, 통계적으로 유의한 차이가 나타났다(p< .000). 흡입기가 부착된 일체형 후두경의 개발은 입 안의 이물질이 있는 경우 좀 더 유용하게 이물질을 제거하고 기관내 삽관을 시행할 수 있는 유용한 장비이다.

This study aims to develop a laryngoscope that can more quickly remove foreign substances in the mouth and perform endotracheal intubation and confirm its usefulness. A laryngoscope suitable for the purpose was manufactured and conducted on 30 fourth-year students at H University. The experimental method was to perform oral suction and endotracheal intubation after inserting a laryngoscope when there was no foreign material, and when there was a foreign material, endotracheal intubation was performed using a laryngoscope with an aspirator attached. When a foreign body was present, suction was performed using the existing method and the developed integrated laryngoscope. The suction time was shorter when the integrated laryngoscope was used than the existing method, and a statistically significant difference was found (p< .000). In the case of the time required for endotracheal intubation, the time required for endotracheal intubation was shorter when the integrated laryngoscope was used than the conventional method, and a statistically significant difference was found (p< .000). The development of an integrated laryngoscope with an aspirator is a useful device that can more effectively remove foreign substances and perform endotracheal intubation when there are foreign substances in the mouth.

키워드

과제정보

본 논문은 2021년도 호남대학교 교내 학술연구비 지원을 받아 수행되었음.

참고문헌

  1. G. Kovacs, J-A. Law, C. McCrossin, M. Vu, D. Leblanc and J. Gao, 'A Comparison of a fiberoptic stylet and a Bougie as adjuncts to direct laryngoscopy in a manikin simulated difficult airway', Ann Emerg Med, Vol.50, no.6, pp.676-685, 2007. https://doi.org/10.1016/j.annemergmed.2007.05.022
  2. A. Calvin, C. John, J-C. Sakles and N-W. Mick, 'The Walls Manual of Emergency Airway Management 5th Edition', Wolters Kluwer, 2018.
  3. G-J. Suh, 'Endotracheal Intubation in Emergency Department', Journal of The Korean Society of Emergency Medicine, Vol.9, no.4, pp.560-570, 1998.
  4. N. Stocchetti, A. Furlan and F. Volta, 'Hypoxemia and arterial hypotension at the accident scene in head injury', J Trauma, Vol.4, no.5, pp.764-767, 1996. https://doi.org/10.1097/00005373-199605000-00014
  5. R-M. Chesnut, L-F. Marshall, M-R. Klauber, B-A. Blunt, N. Baldwin, H-M. Eisenberg, J-A. Jane, A. Marmarou and M-A. Foulkes, 'The role of secondary brain injury in determining outcome from severe head injury', J Trauma, Vol.34, no.2, pp.216-222, 1993. https://doi.org/10.1097/00005373-199302000-00006
  6. K. Ruetzler, S. Leung, M. Chmiela, E. Rivas, L. Szarpak, S. Khanna, G. Mao, R-L. Drake, D-I. Sessler and A. Turan et al, 'Regurgitation and pulmonary aspiration during cardio-pulmonary resuscitation (CPR) with a laryngeal tube: A pilot crossover human cadaver study', PLoS One, Vol.14, no.2, pp.1-10, 2019. https://doi.org/10.1371/journal.pone.0212704
  7. A-H. Travers, T-D. Rea, B-J. Bobrow, D-P. Edelson, R-A. Berg and M-R. Sayre, '2010 American Heart Association Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care', Circulation, Vol.122, no.3, pp.640-656, 2010. https://doi.org/10.1161/CIRCULATIONAHA.110.970913
  8. C-D. Deakin, J-P. Nolan, J. Soar, K. Sunde, R-W. Koster, and G- BSmith et al, 'European Resuscitation Council Guidelines for Resuscitation 2010 Section 4. Adult advanced life support', Resuscitation, Vol.88, no.10, pp.1305-1352, 2010.
  9. I-S. Yu, H. Kim, Y-G. Min, J-Y. Baek, C-S. Bong, T-H. Eom and J-H. Jeong, 'Guideline for Emergency Medical Technicion', National Emergency Medical Center of National Medical Center, 2007.
  10. J-K. Johansen, L. Wik and P-A. Steen, 'Advanced cardiac life support before and after tracheal intubation-direct measurements of quality', Resuscitation, Vol.68, no.1, pp.61-69, 2010. https://doi.org/10.1016/j.resuscitation.2005.05.020
  11. H-H. Oh and E-S. Choi, 'Operating conditions and satisfaction in a clinical training program for 119 emergency medical technicians', Korean J Emerg Med Ser, Vol.19, no.2, pp.99-115, 2015. https://doi.org/10.14408/KJEMS.2015.19.2.099
  12. J-M. Lee, J-H. Choi and Y-G. Shin, 'The Effectiveness of a Modified Laryngoscope Blade on Reducing the Potential of Dental Trauma', Korean Journal of Anesthesiology, Vol.45, no.3, pp.310-314, 2003. https://doi.org/10.4097/kjae.2003.45.3.310
  13. D-V. Bizzarri, and J-G. Giuffrida, 'Improved laryngoscope blade designed for ease of manipulation and reduction of trauma', Anesthesia & Analgesia, Vol.37, no.4, pp.231-232, 1958. https://doi.org/10.1213/00000539-195807000-00017
  14. M-J. Bucx, C-J. Snijders, M-H. ven der Vegt, J-D. Holstein and T. Stijnen, 'Reshaping the Macintosh blade using biomechanical modelling. A prospective comparative study in patients', Anaesthesia, Vol.52, no.7, pp.662-667, 1997. https://doi.org/10.1111/j.1365-2044.1997.134-az0133.x
  15. E-P. McCoy and R-K. Mirakhur, 'The levering laryngoscope', Anaesthesia, Vol.48, no.6, pp.516-519, 1993. https://doi.org/10.1111/j.1365-2044.1993.tb07075.x
  16. C-P. Bellhouse, 'An angulated laryngoscope for routine and difficult tracheal intubation', Anesthesiology, Vol.69, no.1, pp.126-129, 1988. https://doi.org/10.1097/00000542-198807000-00024
  17. B-J. Upban and S-W. Weitzner, 'Avoidance of hypoxia during endotracheal suction', Anesthesiology, Vol.3, no.5, pp.126-129, 1969. https://doi.org/10.1097/00000542-196911000-00024
  18. T-C. Tung, W-S. Tseng, C-T. Chen, J-P. Lai and Y-R. Chen, 'Acute life- threatening injuries in facial fracture patients: a reviewof 1.025 patients', J trauma, Vol.49, no.3, pp.420-424, 2000. https://doi.org/10.1097/00005373-200009000-00006
  19. P-E. Pepe, M-K. Copass, and T. H. Joyce, 'Prehospital endotracheal intubation: Rationale for training emergency medical personnel', Annals of Emergency Medicine, Vol.14, no.11, pp.1085-1092, 1985. https://doi.org/10.1016/S0196-0644(85)80927-6
  20. G-k Shin and Y-J Tak, 'Assessment of the proficiency and usability of direct laryngoscopy and video laryngoscop', Korean J Emerg Med Ser. Vol.23, no.1, pp.87-99, 2019.
  21. F-J. Benjamin, D. Boon and R-A, French . 'An evaluation of the glidescope, a new video laryngoscope for difficult airways: a manikin study'. Eur J Anaesthesiol, Vol.23, no.6, pp.87-99, 2006. https://doi.org/10.1017/S0265021506000147