Pediatric Intubation During Emergency Conditions
Study Details
Study Description
Brief Summary
The effectiveness of endotracheal intubation in pre-hospital conditions is insufficient - especially in the context of pediatric patients. Anatomical differences in pediatric patients compared to adults: a relative larger tongue, a larger and more flabby epiglottis - located more cephalously - that make intubation is more difficult than for adults. Also, higher oxygen metabolism requires the immediate response of medical personnel to children in case of need to protect the airways and support breath.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Normal airway scenario intubation in normal airway scenario |
Device: Macintosh laryngoscope
intubation will be performed using standard direct laryngoscopy - Macintosh laryngoscope
Other Names:
Device: Miller laryngoscope
intubation will be performed using Miller laryngoscope
Other Names:
Device: McGrath MAC EMS
intubation will be performed using McGrath MAC EMS video - laryngoscope
Other Names:
Device: GlideScope
intubation will be performed using GlideScope video - laryngoscope
Other Names:
|
| Experimental: Tongue edema scenario intubation in the tongue edema scenario. Tongue edema was obtain using simulator indicators |
Device: Macintosh laryngoscope
intubation will be performed using standard direct laryngoscopy - Macintosh laryngoscope
Other Names:
Device: Miller laryngoscope
intubation will be performed using Miller laryngoscope
Other Names:
Device: McGrath MAC EMS
intubation will be performed using McGrath MAC EMS video - laryngoscope
Other Names:
Device: GlideScope
intubation will be performed using GlideScope video - laryngoscope
Other Names:
|
| Experimental: Spinal immobilization with normal airway scenario intubation in spinal immobilization with normal airway scenario |
Device: Macintosh laryngoscope
intubation will be performed using standard direct laryngoscopy - Macintosh laryngoscope
Other Names:
Device: Miller laryngoscope
intubation will be performed using Miller laryngoscope
Other Names:
Device: McGrath MAC EMS
intubation will be performed using McGrath MAC EMS video - laryngoscope
Other Names:
Device: GlideScope
intubation will be performed using GlideScope video - laryngoscope
Other Names:
|
| Experimental: Spinal immobilization with tongue edema scenario endotracheal intubation with immobilized cervical spine and tongue edema scenario |
Device: Macintosh laryngoscope
intubation will be performed using standard direct laryngoscopy - Macintosh laryngoscope
Other Names:
Device: Miller laryngoscope
intubation will be performed using Miller laryngoscope
Other Names:
Device: McGrath MAC EMS
intubation will be performed using McGrath MAC EMS video - laryngoscope
Other Names:
Device: GlideScope
intubation will be performed using GlideScope video - laryngoscope
Other Names:
|
Outcome Measures
Primary Outcome Measures
- Intubation time [1 day]
time in seconds required for a successful intubation attempt
Secondary Outcome Measures
- Success of intubation [1 day]
If the oesopharyngeal tube was incorrectly placed or intubation lasted longer than 60 seconds, the airway-management attempt was defined as a failure.
- Cormack-Lehane grading [1 day]
self-reported percentage the vocal cord visualization using the Cormack-Lehane grading, scale developed by Cormack and Lehane, based on four degrees of visibility of the glottis.
- POGO score - percentage of glottic opening [1 day]
self-reported percentage the vocal cord visualization. A 100% POGO score is a full view of the glottis from the anterior commissure to the interarytenoid notch. A POGO score of 0 means that even the interarytenoid notch is not seen.
- Preferred ETI device [1 day]
participants were asked which method of ETI they would prefer in a real-life resuscitation.
- Ease of use [1 day]
self-reported percentage the vocal cord visualization. A 100% score is a extremely difficult procedure. A Ease of use score of 1% means that procedure is extremely easy
Eligibility Criteria
Criteria
Inclusion Criteria:
-
paramedics
-
give voluntary consent to participate in the study
-
none experience in videolaryngoscopy
-
less than 1 year experience in medicine
Exclusion Criteria:
-
not meet the above criteria
-
wrist or low back diseases
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Lazarsku University | Warsaw | Masovian | Poland | 02-662 |
Sponsors and Collaborators
- Lazarski University
- Wroclaw Medical University
- The Cleveland Clinic
- Medical University of Vienna
Investigators
- Principal Investigator: Lukasz Szarpak, PhD, Lazarski University
Study Documents (Full-Text)
None provided.More Information
Publications
- Madziala M, Smereka J, Dabrowski M, Leung S, Ruetzler K, Szarpak L. A comparison of McGrath MAC® and standard direct laryngoscopy in simulated immobilized cervical spine pediatric intubation: a manikin study. Eur J Pediatr. 2017 Jun;176(6):779-786. doi: 10.1007/s00431-017-2909-9. Epub 2017 Apr 21.
- Szarpak Ł, Karczewska K, Czyżewski Ł, Truszewski Z, Kurowski A. Airtraq Laryngoscope Versus the Conventional Macintosh Laryngoscope During Pediatric Intubation Performed by Nurses: A Randomized Crossover Manikin Study With Three Airway Scenarios. Pediatr Emerg Care. 2017 Nov;33(11):735-739. doi: 10.1097/PEC.0000000000000741.
- Szarpak L, Kurowski A, Czyzewski L, Rodríguez-Núñez A. Video rigid flexing laryngoscope (RIFL) vs Miller laryngoscope for tracheal intubation during pediatric resuscitation by paramedics: a simulation study. Am J Emerg Med. 2015 Aug;33(8):1019-24. doi: 10.1016/j.ajem.2015.04.054. Epub 2015 Apr 30.
- ETI_2018_PALS