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首页> 外文期刊>The American journal of emergency medicine >External laryngeal manipulation does not improve the intubation success rate by novice intubators in a manikin study
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External laryngeal manipulation does not improve the intubation success rate by novice intubators in a manikin study

机译：在人体模型研究中，外部喉咙操作不能提高新手插管者的插管成功率

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Background: External laryngeal manipulation (ELM) is a technique used in cases of poor glottic view in direct laryngoscopy. Studies investigating ELM in the pediatric population are lacking. The objective of this study was to examine if use of ELM by inexperienced intubators improves the success rate of pediatric intubation. Methods: We conducted a randomized, controlled, manikin study comparing intubation using ELM (study subjects) with standard intubation (controls). Study participants were paramedic students. Each participant performed 1 intubation attempt on 3 different pediatric airway manikins, independently. If an optimal Cormack-Lehane glottic view (CLGV) of more than 2 has been obtained, study subjects were previously instructed to perform the intubation using ELM; controls were instructed to continue with standard intubation. Outcome measures were single-attempt intubation success rate, preintubation CLGV, and duration of intubation. Results: The study group included 13 subjects who performed 39 intubations. In 19 intubations, CLGV of more than 2 had been obtained; and ELM was used. The control group included 14 subjects who performed 42 intubations. In 20 intubations, CLGV of more than 2 was obtained. Median CLGV score improved from 3.5 before ELM to 2 when ELM was used. However, no difference was found between the groups in intubation success rate (10/19 vs 14/20, P =.43); and the duration of intubation was significantly shorter in controls (25.8 vs 37.8 seconds, P <.007). Conclusions: In this pediatric manikin study, ELM performed by novice intubators improved laryngeal view, but lengthened the duration of intubation and did not improve intubation success rate.
机译：背景：喉外操纵术（ELM）是在直接喉镜检查中声门视野较差的情况下使用的一种技术。缺乏针对儿童人群中ELM的研究。这项研究的目的是检查没有经验的插管者使用ELM是否可以提高小儿插管的成功率。方法：我们进行了一项随机，对照，人体模型研究，比较了使用ELM（研究对象）和标准插管（对照）进行插管的情况。研究参与者是护理人员学生。每个参与者分别对3种不同的小儿气道人体模型进行了1次插管尝试。如果获得的最佳Cormack-Lehane声门视野（CLGV）大于2，则事先指示研究对象使用ELM进行插管;指示对照组继续进行标准插管。结果指标为单次尝试插管成功率，插管前CLGV和插管持续时间。结果：研究组包括13位受试者，进行了3​​9次插管。在19个插管中，获得的CLGV大于2。并且使用了ELM。对照组包括14名受试者，他们进行了42次插管。在20个插管中，CLGV大于2。中位数CLGV评分从ELM之前的3.5提高到使用ELM时的2。但是，两组之间的插管成功率没有差异（10/19 vs 14/20，P = .43）。对照组的插管时间明显缩短（25.8 vs 37.8秒，P <.007）。结论：在该儿科人体模型研究中，新手插管者进行的ELM改善了喉镜视野，但延长了插管时间，并没有提高插管成功率。

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