Abstract
Supraglottic airway devices (SADs) have been introduced to assist medical professionals in emergency situations with limited experience in securing airways via conventional endotracheal intubation (ETI). Literature on the use of SADs for securing an airway during pediatric critical settings is scarce, and there is a lack of studies comparing different SADs to each other and to conventional ETI. We conducted a study comparing five different SADs to ETI with regard to success rate, time to first ventilation, and personal rating in a pediatric manikin under simulated physiologic and pathologic airway conditions in 41 pediatricians of varying clinical experience and training. Only the AirQ, AuraG, and laryngeal tube (LT) were inserted within 30 s correctly by all participants under physiologic conditions. In tongue edema (TE), AirQ and LT had the highest success rate. In limited mobility of the cervical spine (CS), AirQ, AuraG, and LT again all were inserted within 30 s. In a multivariate analysis, factors influencing the success were experience with the respective device and level of medical education. Under TE conditions, there were significantly longer insertion times for the ETI, laryngeal mask airway (LMA), and EzT. Under CS conditions, there were significantly longer insertion times for the ETI, LMA, LT, and EzT. A multivariate analysis showed experience with the respective device to be the only factor of influence on time to first ventilation.Conclusion: LT, AuraG, and AirQ were superior in providing fast and effective ventilation during simulated difficult airway situations in pediatricians.What is Known:• Supraglottic airway devices have been introduced for medical professionals who lack experience for managing difficult airway situations.• A variety of these devices have been developed so far, but not compared to each other yet.What is New:• We compared five different supraglottic airway devices with regard to success rate, time to first ventilation, and personal rating in a pediatric manikin under simulated physiologic and pathologic airway conditions.• Laryngeal tube, AuraG, and AirQ were superior in providing fast and effective ventilation during simulated difficult airway situations in pediatricians with varying clinical experience.
Highlights
In the setting of a pediatric emergency, pediatricians must be able to provide basic airway management
Supraglottic airway devices have been introduced for medical professionals who lack experience for managing difficult airway situations
The aim of this study was to provide evidence for a recommendation regarding the use of supraglottic airway devices (SADs) in pediatric difficult airway situations utilizing simulation of abnormal airway conditions
Summary
In the setting of a pediatric emergency, pediatricians must be able to provide basic airway management. The current gold standard for securing an airway is endotracheal intubation (ETI) [7, 15]. The skills required to perform ETI successfully are usually acquired in training, but many pediatricians do not use them frequently. Because only a small percentage (5– 10%) of out-of-hospital EMS calls is for pediatric patients, many paramedics may have limited experience in working with children. Patient outcomes after pediatric cardiopulmonary arrest are dismal and have not improved over the last three decades [25]. When an emergency occurs, the best chance for intact survival of the child is determined by adequate airway management
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
