Optimization of glottic exposure during intubation of a patient lying supine on the ground

Two methods of endotracheal intubation of patients lying on the ground were compared for ease and speed of intubation and minimization of complications in a crossover study of prehospital-oriented emergency physicians. Intubation of a mannequin was attempted by the physicians in either a left latera...

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Bibliographic Details
Published in:The American journal of emergency medicine 1997-10, Vol.15 (6), p.555-557
Main Authors: Adnet, Frédéric, Lapostolle, Frédéric, Borron, Stephen W, Hennequin, B, Leclercq, G, Fleury, M
Format: Article
Language:English
Subjects:
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Cross-Over Studies
Emergency and intensive care: techniques, logistics
Emergency Medicine - methods
Endotracheal intubation
Glottis
Humans
Intensive care medicine
Intensive care unit. Emergency transport systems. Emergency, hospital ward
Intubation, Intratracheal - adverse effects
Intubation, Intratracheal - methods
Laryngoscopy - adverse effects
Laryngoscopy - methods
Manikins
Medical sciences
Physical Examination - standards
prehospital care
Supine Position
techniques
Time Factors
Tooth Injuries - etiology
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Summary:Two methods of endotracheal intubation of patients lying on the ground were compared for ease and speed of intubation and minimization of complications in a crossover study of prehospital-oriented emergency physicians. Intubation of a mannequin was attempted by the physicians in either a left lateral decubitus (LLD) position or a kneeling (K) position, followed by the alternate position. The LLD position afforded more rapid intubation, better glottic visualization, and less dental trauma. Eighty-seven percent of physicians completely visualized the glottis in the LLD position, versus 33% of the K position group. Intubation times were 10.5 versus 14.6 seconds in the LLD and K positions, respectively ( P < .001). The LLD position is a more effective position (in a mannequin model) than the K position for intubation of patients found lying on the ground, a frequent situation in prehospital care.
ISSN:0735-6757
1532-8171
DOI:10.1016/S0735-6757(97)90155-8