Sang O Park1, Jong Won Kim2, Joon Ho Na3, Ki Ho Lee3, Kyeong Ryong Lee2, Dae Young Hong2, Kwang Je Baek2. 1. Department of Emergency Medicine, School of medicine, Konkuk University, Konkuk University Medical Center, Seoul, Republic of Korea. Electronic address: empso@kuh.ac.kr. 2. Department of Emergency Medicine, School of medicine, Konkuk University, Konkuk University Medical Center, Seoul, Republic of Korea. 3. Department of Emergency Medicine, International St. Mary's Hospital, Incheon, Republic of Korea.
Abstract
AIM: To compare the first-attempt success in endotracheal intubation (ETI) during cardiopulmonary resuscitation (CPR) using direct laryngoscopy (DL) and video laryngoscopy (VL) (GlideScope(®)) among novice emergency physicians (EPs). METHODS: This study is a historically controlled clinical design. From May 2011 to April 2013 out-of-hospital cardiac arrest patients were intubated during CPR by novice EPs. CPR data was automatically recorded by pre-installed video and subsequently analysed. The primary outcome was the success rate of the first-attempt at ETI. In addition, time to successful ETI from first-attempt (T-complete), duration of chest compression interruptions, and incidence of oesophageal intubation were compared. RESULTS: Of 305 patients undergoing ETI, 83 were intubated by novice EPs. The success rate of first-attempt ETI in the VL group (n=49) was higher than that in the DL group (n=34, 91.8% vs. 55.9%; p<0.001). The median T-complete was significantly shorter with VL than with DL (37 [29-55] vs. 62 [56-110] s; p<0.001). Oesophageal intubation was observed only in the DL group (n=6, 17.6%). The median duration of chest compression interruptions was greater with DL (7 [3-6] s) than with VL (0 [0-0] s). Improvements in ETI during CPR were observed in the VL group after the first 3 months, but not the DL group during regular use for 1 year. CONCLUSIONS: For novice EPs, the VL could significantly improve the first-attempt success in ETI during CPR while the DL couldn't improve it.
AIM: To compare the first-attempt success in endotracheal intubation (ETI) during cardiopulmonary resuscitation (CPR) using direct laryngoscopy (DL) and video laryngoscopy (VL) (GlideScope(®)) among novice emergency physicians (EPs). METHODS: This study is a historically controlled clinical design. From May 2011 to April 2013 out-of-hospital cardiac arrestpatients were intubated during CPR by novice EPs. CPR data was automatically recorded by pre-installed video and subsequently analysed. The primary outcome was the success rate of the first-attempt at ETI. In addition, time to successful ETI from first-attempt (T-complete), duration of chest compression interruptions, and incidence of oesophageal intubation were compared. RESULTS: Of 305 patients undergoing ETI, 83 were intubated by novice EPs. The success rate of first-attempt ETI in the VL group (n=49) was higher than that in the DL group (n=34, 91.8% vs. 55.9%; p<0.001). The median T-complete was significantly shorter with VL than with DL (37 [29-55] vs. 62 [56-110] s; p<0.001). Oesophageal intubation was observed only in the DL group (n=6, 17.6%). The median duration of chest compression interruptions was greater with DL (7 [3-6] s) than with VL (0 [0-0] s). Improvements in ETI during CPR were observed in the VL group after the first 3 months, but not the DL group during regular use for 1 year. CONCLUSIONS: For novice EPs, the VL could significantly improve the first-attempt success in ETI during CPR while the DL couldn't improve it.
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