Comparing the effectiveness of airway management devices in pre-hospital emergency care: A randomized clinical trial.

Shahla Khosravan,Arash Hamzei,Ali Alami,Jalal Borna

doi:10.12669/pjms.314.7296

Abstract

Objective:To assess the effectiveness of laryngeal mask airway, endotracheal tube and oropharyngeal airway for airway management in prehospital emergency care.Methods:The study sample of this randomized clinical trial was 54 patients needing pre-hospital airway management. All cases of intubation (ETI); after two failed attempts (37 patients), were randomly assigned to the oropharyngeal airway (OPA), and the laryngeal mask airway (LMA) groups. Patients’ hemodynamic, SaO2 and airway management parameters, were compared in three groups. The study data were analyzed by the Chi-square and one-way ANOVA, Bonferroni post-hoc, using SPSS, v. 18.0.Results:The results demonstrated that before and after the study, there was no significant difference among the study groups in terms of hemodynamic variables (P > 0.05) expect SaO2 (P < 0.001). The results also revealed that in the ETI group (n=17), the number of attempts and the time spent on inserting the airway device was significantly more than other two groups (P < 0.05).Conclusion:Laryngeal mask airway is as effective as oropharyngial airway for pre-hospital airway management by paramedics.

Highlights

Airway obstruction—and subsequent oxygen deprivation—is an immediate threat to life and a real emergency.[1,2] Pre-hospital paramedics should be well qualified and prepared to manage patients airway with inadequate ventilation.[3]Endotracheal intubation (ETI) is the gold standard for maintaining a patient airway.[4]
The results demonstrated that before and after the study, there was no significant difference among the study groups in terms of DBP, SBP, heart rate (HR), and SaO2 (P > 0.05; Table-II)
This finding implies that laryngeal mask airway (LMA) is more effective than oropharyngeal airway (OPA) in improving SaO2 levels, and as much effective as ETI which is the gold standard for maintaining a patient airway

Summary

Introduction

Airway obstruction—and subsequent oxygen deprivation—is an immediate threat to life and a real emergency.[1,2] Pre-hospital paramedics should be well qualified and prepared to manage patients airway with inadequate ventilation.[3]Endotracheal intubation (ETI) is the gold standard for maintaining a patient airway.[4]. Using OPA, patients maybe receive lower concentrations of oxygen and lower tidal volume.[10]

Methods

Results

Conclusion