Skip Navigation


BJA Advance Access originally published online on December 24, 2007
British Journal of Anaesthesia 2008 100(3):351-356; doi:10.1093/bja/aem364
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
100/3/351    most recent
aem364v1
Right arrow E-Letters: Submit a response to the article
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Gatward, J. J.
Right arrow Articles by Cook, T. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gatward, J. J.
Right arrow Articles by Cook, T. M.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?


© The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Effect of chest compressions on the time taken to insert airway devices in a manikin

J. J. Gatward*, M. J. C. Thomas, J. P. Nolan{dagger} and T. M. Cook{dagger}

Department of Anaesthesia, Royal United Hospital, Combe Park, Bath BA1 3NG, UK

* Corresponding author. E-mail: jongatward{at}hotmail.com

Background: Resuscitation guidelines recommend that chest compressions should continue throughout attempts to place airway devices. Few data support the use of the tracheal tube over supraglottic airway devices (SADs) during cardiopulmonary arrest. This study was designed to evaluate the speed with which different airway devices could be placed with and without interrupting chest compressions.

Methods: Forty volunteer doctors regularly involved in cardiopulmonary resuscitation (CPR) were timed inserting four different airway devices [tracheal tube (TT), LMATM Classic (cLMA), LMATM ProSeal (PLMA), and igelTM] into a manikin, with and without stopping chest compressions.

Results: Chest compressions delayed the placement of the TT only (3.3 s, P<0.0001). Comparison of the speed of insertion of the different airway devices during CPR enabled ranking of the devices: igel (fastest), PLMA (second), and TT and cLMA (joint slowest). The igel was inserted approximately 50% faster than the other devices. Doctors who had previously inserted more than 50 tracheal tubes were significantly faster at intubating the trachea, but no faster at inserting SADs.

Conclusions: Our results show that continuing chest compressions has a minor effect on time for tracheal intubation and until clear human data are available the recommendation to intubate without interrupting CPR is therefore justified. The PLMA and igel (SADs with a gastric drain tube) were both faster to insert than the cLMA and offer additional benefits. They should be considered for use in CPR.

Keywords: equipment, masks anaesthesia; equipment, models; equipment, tubes tracheal; heart, cardiac massage; heart, resuscitation

{dagger} Declaration of interest. The igels used in this study were donated free by the manufacturers (Intersurgical, Wokingham, UK). T.M.C. has received payment for lecturing from Intavent Orthofix and the LMA Company, both of which manufacture laryngeal mask airways. J.P.N. was co-author of the European Resuscitation Council Advanced Life Support Guidelines.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.