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首页> 外文期刊>Prehospital emergency care >Paramedic King Laryngeal tube airway insertion versus endotracheal intubation in simulated pediatric respiratory arrest
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Paramedic King Laryngeal tube airway insertion versus endotracheal intubation in simulated pediatric respiratory arrest

机译：模拟小儿呼吸骤停时辅助喉镜国王气管插管与气管插管的比较

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Introduction: Pediatric endotracheal intubation (ETI) is difficult and can have serious adverse events when performed by paramedics in the prehospital setting. Paramedics may use the King Laryngeal Tube airway (KLT) in difficult adult airways, but only limited data describe their application in pediatric patients. Objective: To compare paramedic airway insertion speed and complications between KLT and ETI in a simulated model of pediatric respiratory arrest. Methods: This prospective, randomized trial included paramedics and senior paramedic students with limited prior KLT experience. We provided brief training on pediatric KLT insertion. Using a random allocation protocol, participants performed both ETI and KLT on a pediatric mannequin (6-month old size) in simulated respiratory arrest. The primary outcomes were 1) elapsed time to successful airway placement (seconds), and 2) proper airway positioning. We compared airway insertion performance between KLT and ETI using the Wilcoxon signed-ranks test. Subjects also indicated their preferred airway device. Results: The 25 subjects included 19 paramedics and 6 senior paramedic students. Two subjects had prior adult KLT experience. Airway insertion time was not statistically different between the KLT (median 27 secs) and ETI (median 31 secs) (p = 0.08). Esophageal intubation occurred in 2 of 25 (8%) ETI. Airway leak occurred in 3 of 25 (12%) KLT, but ventilation remained satisfactory. Eighty-four percent of the subjects preferred the KLT over ETI. Conclusions: Paramedics and paramedic students demonstrated similar airway insertion performance between KLT and ETI in simulated, pediatric respiratory arrest. Most subjects preferred KLT. KLT may provide a viable alternative to ETI in prehospital pediatric airway management.
机译：简介：儿科气管插管（ETI）困难，在院前环境中由护理人员进行时可能会产生严重的不良事件。护理人员可能会在困难的成人气道中使用喉头镜气道（KLT），但只有有限的数据描述了它们在儿科患者中的应用。目的：在小儿呼吸骤停的模拟模型中，比较辅助医护人员的气道插入速度以及KLT和ETI之间的并发症。方法：该前瞻性随机试验包括护理人员和先前在KLT方面经验有限的高级护理人员学生。我们提供了有关儿科KLT插入的简短培训。使用随机分配方案，参与者在模拟呼吸骤停中的小儿模特（6个月大）上进行了ETI和KLT测试。主要结果是1）成功完成气道放置的时间（秒），以及2）正确的气道定位。我们使用Wilcoxon符号秩检验比较了KLT和ETI之间的气道插入性能。受试者还指出了他们偏爱的气道装置。结果：25名受试者包括19名护理人员和6名高级护理人员学生。两名受试者曾有成人KLT经历。气道插入时间在KLT（中位数27秒）和ETI（中位数31秒）之间没有统计学差异（p = 0.08）。 25例ETI中有2例发生了食管插管（8％）。 25例KLT中有3例发生气道渗漏（12％），但通气仍然令人满意。 84％的受试者更喜欢KLT，而不是ETI。结论：在模拟的小儿呼吸骤停中，护理人员和护理人员学生在KLT和ETI之间表现出相似的气道插入性能。大多数受试者更喜欢KLT。在院前儿科气道管理中，KLT可能为ETI提供可行的替代方案。

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