Jacek Smereka1, Jerzy R Ladny2, Amanda Naylor3, Kurt Ruetzler4, Lukasz Szarpak5. 1. Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland. 2. Department of Emergency Medicine and Disaster, Medical University Bialystok, Bialystok, Poland. 3. Outcomes Research Consortium, Cleveland, USA. 4. Department of Outcomes Research, Anaesthesiology Institute, Cleveland Clinic, Cleveland, USA; Department of General Anaesthesiology, Anaesthesiology Institute, Cleveland Clinic, Cleveland, USA. Electronic address: kurt.ruetzler@reflex.at. 5. Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland.
Abstract
INTRODUCTION: The aim of this study was to compare C-MAC videolaryngoscopy with direct laryngoscopy for intubation in simulated cervical spine immobilization conditions. METHODS: The study was designed as a prospective randomized crossover manikin trial. 70 paramedics with <5years of medical experience participated in the study. The paramedics attempted to intubate manikins in 3 airway scenarios: normal airway without cervical immobilization (Scenario A); manual inline cervical immobilization (Scenario B); cervical immobilization using cervical extraction collar (Scenario C). RESULTS: Scenario A: Nearly all participants performed successful intubations with both MAC and C-MAC on the first attempt (95.7% MAC vs. 100% C-MAC), with similar intubation times (16.5s MAC vs. 18s C-MAC). Scenario B: The results with C-MAC were significantly better than those with MAC (p<0.05) for the time of intubation (23 s MAC vs. 19 s C-MAC), success of the first intubation attempt (88.6% MAC vs. 100% C-MAC), Cormack-Lehane grade, POGO score, severity of dental compression, device difficulty score, and preferred airway device. Scenario C: The results with C-MAC were significantly better than those with MAC (p<0.05) for all the analysed variables: success of the first attempt (51.4% MAC vs. 100% C-MAC), overall success rate, intubation time (27 s MAC vs. 20.5 s C-MAC), Cormack-Lehane grade, POGO score, dental compression, device difficulty score and the preferred airway device. CONCLUSION: The C-MAC videolaryngoscope is an excellent alternative to the MAC laryngoscope for intubating manikins with cervical spine immobilization.
RCT Entities:
INTRODUCTION: The aim of this study was to compare C-MAC videolaryngoscopy with direct laryngoscopy for intubation in simulated cervical spine immobilization conditions. METHODS: The study was designed as a prospective randomized crossover manikin trial. 70 paramedics with <5years of medical experience participated in the study. The paramedics attempted to intubate manikins in 3 airway scenarios: normal airway without cervical immobilization (Scenario A); manual inline cervical immobilization (Scenario B); cervical immobilization using cervical extraction collar (Scenario C). RESULTS: Scenario A: Nearly all participants performed successful intubations with both MAC and C-MAC on the first attempt (95.7% MAC vs. 100% C-MAC), with similar intubation times (16.5s MAC vs. 18s C-MAC). Scenario B: The results with C-MAC were significantly better than those with MAC (p<0.05) for the time of intubation (23 s MAC vs. 19 s C-MAC), success of the first intubation attempt (88.6% MAC vs. 100% C-MAC), Cormack-Lehane grade, POGO score, severity of dental compression, device difficulty score, and preferred airway device. Scenario C: The results with C-MAC were significantly better than those with MAC (p<0.05) for all the analysed variables: success of the first attempt (51.4% MAC vs. 100% C-MAC), overall success rate, intubation time (27 s MAC vs. 20.5 s C-MAC), Cormack-Lehane grade, POGO score, dental compression, device difficulty score and the preferred airway device. CONCLUSION: The C-MAC videolaryngoscope is an excellent alternative to the MAC laryngoscope for intubating manikins with cervical spine immobilization.
Authors: Togay Evrin; Jacek Smereka; Damian Gorczyca; Szymon Bialka; Jerzy Robert Ladny; Burak Katipoglu; Lukasz Szarpak Journal: Emerg Med Int Date: 2019-08-20 Impact factor: 1.112
Authors: Katarzyna Karczewska; Szymon Bialka; Jacek Smereka; Maciej Cyran; Grazyna Nowak-Starz; Jaroslaw Chmielewski; Michal Pruc; Pawel Wieczorek; Frank William Peacock; Jerzy Robert Ladny; Lukasz Szarpak Journal: J Clin Med Date: 2021-11-25 Impact factor: 4.241
Authors: Andrzej Bielski; Eva Rivas; Kurt Ruetzler; Jacek Smereka; Mateusz Puslecki; Marek Dabrowski; Jerzy R Ladny; Michael Frass; Oliver Robak; Togay Evrin; Lukasz Szarpak Journal: Medicine (Baltimore) Date: 2018-10 Impact factor: 1.817
Authors: Lukasz Szarpak; Agnieszka Madziala; Michael Czekajlo; Jacek Smereka; Alexander Kaserer; Marek Dabrowski; Marcin Madziala; Ruslan Yakubtsevich; Jerzy Robert Ladny; Kurt Ruetzler Journal: Medicine (Baltimore) Date: 2018-09 Impact factor: 1.817
Authors: Leszek Gadek; Lukasz Szarpak; Lars Konge; Marek Dabrowski; Dominika Telecka-Gadek; Maciej Maslanka; Wiktoria Laura Drela; Marta Jachowicz; Lukasz Iskrzycki; Szymon Bialka; Frank William Peacock; Jacek Smereka Journal: J Clin Med Date: 2021-12-08 Impact factor: 4.241