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IF 2.8 3区医学 Q1 Pharmacology, Toxicology and Pharmaceutics Therapeutics and Clinical Risk Management Pub Date : 2025-01-25 eCollection Date: 2025-01-01 DOI:10.2147/TCRM.S486978

Kasamon Aramvanitch, Sittichok Leela-Amornsin, Welawat Tienpratarn, Promphet Nuanprom, Supassorn Aussavanodom, Chaiyaporn Yuksen, Sirinapa Boonsri, Natcha Boonjarus, Somchoak Sanepim

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引用次数: 0

摘要

导言：颈椎活动受限的外伤患者由于颈部活动和张口受限，很难进行气管插管（ETI）。然而，在院前环境中去除颈圈进行 ETI 可能会导致神经功能恶化。本研究比较了在人体模型上使用视频喉镜（VL）进行 ETI 的成功率，并对比了无颈椎硬颈圈的人工在线稳定（MILS）和完全固定：我们进行了一项随机、非交叉研究，56 名医护学生被 SNOSE 分配到不同大小的插管盒中，在人体模型上使用不带颈椎硬袢的 MILS 或完全固定技术进行 VL 插管。主要结果是插管成功率。次要结果包括尝试次数、成功插管时间和 Cormack-Lehane 分级：对 56 名参与者进行了评估，其中 28 人属于完全固定组，另外 28 人属于无颈椎硬袢 MILS 组。两组的基线特征无差异。完全固定组和无颈椎硬袢 MILS 组的 VL 插管成功率无差异（28 [100%] vs 28 [100%]；首次尝试 24 [85.71%] vs 27 [96.43%]；第二次尝试 4 [14.29%] vs 1 [3.57%]；P 值 0.352）。成功插管所需的时间（中位数[IQR] 17.20 [12.53, 24.40] vs 17.53 [14.06, 23.73]，P 值 0.694）和 Cormack-Lehane 分级（I 级 11 [39.29%] vs 10 [35.71%]；Ⅱ级为 16 [57.14%] vs 17 [60.71%]；Ⅲ级为 1 [3.57%] vs 1 [3.57%]，P 值为 1.000），两组间无统计学差异：结论：在使用视频喉镜进行气管插管时，无需取下颈部硬环。

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Video Laryngoscopy for Endotracheal Intubation: A Consideration for Manual In-Line Stabilization Without Cervical Collar Versus Full Immobilization.

Introduction: Traumatic patients with cervical spine motion restriction have difficulty with endotracheal intubation (ETI) due to the limitations of neck movement and mouth opening. Nevertheless, the removal of the cervical collar for ETI in a prehospital setting may lead to a deterioration in neurological outcomes. This study compares the success rate of ETI utilizing a video laryngoscope (VL) on a manikin, contrasting manual in-line stabilization (MILS) without a cervical hard collar against full immobilization.

Methods: A randomized, non-crossover study was conducted involving 56 paramedic students assigned by SNOSE to utilize various box sizes for VL intubation with MILS without a cervical hard collar or full immobilization technique on a manikin. The primary outcome was the intubation success rate. Secondary outcomes included attempts, time for successful intubation, and Cormack-Lehane classification.

Results: Fifty-six participants were evaluated; 28 were in the full immobilization group, and another 28 were in the MILS without cervical hard collar group. Baseline characteristics showed no difference between both groups. The success rate of VL intubation showed no difference between the full immobilization group and the MILS without a cervical hard collar group (28 [100%] vs 28 [100%]; 24 [85.71%] vs 27 [96.43%] on first attempt; 4 [14.29%] vs 1 [3.57%] on second attempt; p-value 0.352). Time required to perform successful intubation (median [IQR] 17.20 [12.53, 24.40] vs 17.53 [14.06, 23.73], p-value 0.694) and Cormack-Lehane classification (11 [39.29%] vs 10 [35.71%] in grade I; 16 [57.14%] vs 17 [60.71%] in grade II; 1 [3.57%] vs 1 [3.57%] in grade III, p-value 1.000) showed no statistical difference between the two groups.

Conclusion: It is unnecessary to remove the cervical hard collar when performing endotracheal intubation while using a video laryngoscope.

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来源期刊

Therapeutics and Clinical Risk Management HEALTH CARE SCIENCES & SERVICES-

CiteScore

5.30

自引率

3.60%

发文量

139

审稿时长

16 weeks

期刊介绍： Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas. The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature. As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication. The journal does not accept study protocols, animal-based or cell line-based studies.