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      Comparison of blind intubation with different supraglottic airway devices by inexperienced physicians in several airway scenarios: a manikin study

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          Abstract

          Endotracheal intubation is the gold standard for airway management. Supraglottic airway devices (SADs) are useful in airway abnormalities. SAD blind intubation enables airway management with better ventilation and a reduced risk of gastric content aspiration. The aim was to compare various SADs in blind intubation performed by inexperienced physicians in several pediatric airway scenarios. One hundred sixteen physicians with no previous experience with SAD performed blind endotracheal intubations with (1) iGEL, (2) Air-Q intubating laryngeal airway, and (3) Ambu AuraGain disposable laryngeal mask in a pediatric manikin in three airway scenarios: (A) normal airway without chest compressions, (B) normal airway with continuous chest compressions with the CORPULS CPR system, and (C) difficult airway with continuous chest compressions with the CORPULS CPR system. Intubation tube with 5.0 internal diameter was used for all blind intubation attempts. First intubation success rate, median time to SAD placement, time to endotracheal intubation with SAD, and ease to perform the intubation were investigated in this study. All these parameters were better or non-inferior for iGEL in all investigated scenarios.

          Conclusion: Our manikin study demonstrated that iGEL was the most effective device for blind intubation by inexperienced physicians in different pediatric airway scenarios.

          What is Known:

          • For pediatric resuscitation, bag-mask ventilation is the first-line method for airway control and ventilation.

          • Endotracheal intubation is considered by many scientific societies the gold standard for airway management.

          • Supraglottic airway devices are particularly useful when bag-mask ventilation is difficult or impossible but can be also used for blind intubation.
          What is New:

          • The iGEL laryngeal mask turns out the most effective device for blind intubation by inexperienced physicians in different pediatric airway scenarios.

          • It may be a reasonable first emergency blind intubation technique for inexperienced physicians in pediatric patients in normal airway with and without continuous chest compressions, as well as in difficult airway with continuous chest compressions.

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          Most cited references35

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          Part 12: Pediatric Advanced Life Support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

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            European Resuscitation Council Guidelines for Resuscitation 2015: Section 6. Paediatric life support.

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              Difficult laryngoscopy: obtaining the best view.

              J Benumof (1994)
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                Author and article information

                Contributors
                src.emergency@gmail.com
                smereka.icu@gmail.com
                mmadziala262@gmail.com
                eurecaplus@gmail.com
                (+48) 500186225 , lukasz.szarpak@gmail.com
                Journal
                Eur J Pediatr
                Eur. J. Pediatr
                European Journal of Pediatrics
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0340-6199
                1432-1076
                22 March 2019
                22 March 2019
                2019
                : 178
                : 6
                : 871-882
                Affiliations
                [1 ]Polish Society of Disaster Medicine, Warsaw, Poland
                [2 ]ISNI 0000 0001 1090 049X, GRID grid.4495.c, Department of Emergency Medical Service, , Wroclaw Medical University, ; Wroclaw, Poland
                [3 ]ISNI 0000 0004 0369 1337, GRID grid.445556.3, Lazarski University, ; 43 Swieradowska Str., 02-662 Warsaw, Poland
                Author notes

                Communicated by Mario Bianchetti

                Author information
                http://orcid.org/0000-0002-0973-5455
                Article
                3345
                10.1007/s00431-019-03345-4
                6511343
                30903306
                d1c4f480-6c3c-4431-91d2-df1b56ed7119
                © The Author(s) 2019

                OpenAccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 9 July 2018
                : 9 February 2019
                : 12 February 2019
                Categories
                Original Article
                Custom metadata
                © Springer-Verlag GmbH Germany, part of Springer Nature 2019

                Pediatrics
                endotracheal intubation,child,emergency medicine,difficult airway,medial simulation
                Pediatrics
                endotracheal intubation, child, emergency medicine, difficult airway, medial simulation

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