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Comparison of Endotracheal Intubation in Difficult Postures by Using the SALT(Supraglottic Airway Laryngopharyneal Tube)

  • Yun, Seong-Woo (Dept. of Emergency Medical Service, Namseoul University)
  • 투고 : 2020.11.10
  • 심사 : 2020.11.24
  • 발행 : 2020.12.31

초록

본 연구는 성문위기도기 인후두 튜브(Supraglottic Airway Laryngopharyngeal Tube, SALT)와 직접 후두경을 이용하여 어려운 자세에서 기관내삽관의 신속성과 자신감, 용이성 등을 비교하여 전문기도관리 시행 능력을 향상 시키는데 있다. 연구대상은 J도 소방서에서 근무하고 있는 1급 응급구조사 30명을 대상으로 무작위 교차방법(Randomized crossover design)으로 디자인한 실험연구로 자료 분석은 SPSS 20.0 Version을 사용하였다. 어려운 자세에서 SALT를 이용한 기관내삽관은 직접 후두경을 이용한 기관내삽관 보다 신속성에서 유의한 차이를 보였으며(p<.001), 자신감과 용이성에서도 유의한 차이를 나타냈다(p<.001). 직접 후두경을 사용한 기관내삽관이 어려운 환경이나 외상환자의 경우 SALT를 이용한다면 안전하고 신속한 삽관을 할 수 있을 것이다. 또한 전문기도관리의 효율성 향상을 위해서 국내 현장에 SALT의 도입이 필요 할 것으로 사료된다.

The purpose of this study is to compare the speed, confidence, and ease of endotracheal intubation in a difficult posture by using the SALT(Supraglottic Airway Laryngopharyngeal Tube), and a direct laryngoscope to improve the ability to implement professional airway management. The subject of the study was an experimental study by a randomized crossover design, targeting 30 first-class emergency medical technicians working in J-do fire station, and the SPSS 20.0 version was used for data analysis. The endotracheal intubation by using SALT showed a significant difference in speed compared to endotracheal intubation by using a direct laryngoscope(p<.001), and also showed a significant difference in confidence and ease(p<.001). If it is difficult to endotracheal intubation by direct laryngoscope, or in the case of trauma patients, if SALT is used, safe and rapid intubation will be possible. In addition, to improve the efficiency of professional airway management, it is believed that the introduction of SALT in domestic sites is necessary.

키워드

참고문헌

  1. Y. L. Kim, H. Y. Lee, G. W. Kim, H. S. Jo, J. H. Jung, "Comparative Study of Prehospital Airway Devices Tested Using a Manikin Model: A Comparison of the Laryngeal Mask Airway Classic (LMA Classic(TM)), Cobra Perilaryngeal Airway (Cobra PLA(TM)) and the King Laryngeal Tube (King LT(TM))," J Korean Soc Emerg Med, Vol. 22, No. 6, pp. 776-782, December 2010. http://www.jksem.org/m/journal/view.php?number=542
  2. J. W. Si, S. B. Lee, B. S. Do, "Comparison of the Macintosh laryngoscope and the GlideScope Video laryngoscope in ease and simulated difficult airway scenarios -A manikin study-," J Korean Soc Emerg Med, Vol. 20, No. 6, pp. 604-608, December 2009. http://en.medric.or.kr/Main.aspx?menu=01&d=KMBASE&m=VIEW&i=0385920100210060783
  3. J. H. Park, "Recognition and request for medical direction by 119 emergency medical technicians," Korean J Emerg Med Ser, Vol. 15, No. 3, pp. 31-44, December 2011. http://www.kemt.or.kr/bbs/board.php?bo_table=sub_030302&wr https://doi.org/10.14408/KJEMS.2011.15.3.031
  4. Y. L. Kim, H. Y. Lee, G. W. Kim, H. S. Jo, J. H. Jung, "Comparative study of prehospital airway devices tested using a manikin model: A comparison of the laryngeal mask airway classic(LMA classicTM), cobra Perilaryngeal airway(Cobra PLATM) and the King laryngeal tube(King LTTM)," J Korean Soc Emerg Med, Vol. 22, No. 6, pp. 776-782, December 2010. http://repository.ajou.ac.kr/handle/201003/9307
  5. G. Kovacs, J. MHPE, Law. Adam, Chris. McCrossin, Vu. Mark, Leblanc. Derek, MA. Jun, MS. Gao, "A Comparison of a fiberoptic stylet and a Bougie as adjuncts to direct laryngoscopy in a manikin simulated difficult airway," Annals Emerg Med, Vol. 50, No. 6, pp. 676-685, August 2007. DOI: 10.1016/j.annemergmed.2007.05.022
  6. LD. Matin, JM. Mhyre, AM. Shanks, KK. Tremper, S. Kheterpal, "3,423 Emergency tracheal intubations at a university hospital: airway outcomes and complications," Anesthesiology, Vol. 114, No. 1, pp. 42-48, January 2011. DOI: 10.1097/ALN.0b013e318201c415
  7. JS. Bradley, GL. Billows, ML. Olinger, SP. Boha, WH. Cordell, DR. Nelson, "Prehospital oral endotracheal intubation by rural basic emergency medical technicians," Annals of Emerg Med, Vol. 32, No. 1, pp. 26-32, January 1998. DOI: 10.1016/s0196-0644(98)70095-2
  8. MR. Sayre, JC. Sakles, AF. Mister, JL. Evans, AT. Kramer, and AM. Pancioli, "Field trial of endotracheal intubation by basic EMTs," Annals of emergency medicine, Vol. 3, No. 2, pp. 228-233, February 1998. DOI: .org/10.1016/S0196-0644(98)70312-9
  9. VG. Annad, Girinivasan, Leelakrishna, Thavamani "Evaluation ofthe new supraglottic S.A.L.T to aid blind orotracheal intubation: Apilot study," Int J Crit Illn Inj Sci, Vol. 3, No. 4, pp. 241-245, December 2013. DOI: 10.4103/2229-5151.124112
  10. DG. Ostermayer, M. Gausche-Hill, "Supraglottic airways: The history and current state of prehospital airway adjuncts," Prehosp Emerg Care, Vol. 18, No. 1, pp. 106-115, september 2014. DOI: 10.3109/10903127.2013.825351
  11. BE. Bledsoe, DE. Slattery, R. Lauver, W. Forred, L. Johnson, G. Rigo, "Can emergency medical services personnel effectivity place and use the supraglottic airway laryngopharyngeal tube(SALT) airway?," Prehospital Emergency Care, Vol. 15, No. 3, pp. 359-365 July 2011. DOI: 10.3109/10903127.2011.561410
  12. AG. Garza, MC. Gratton, J. McElroy, D. Lindholm, D. Coontz, (2015) "Environmental factors encountered during out-of-hospital intubation attempts," Prehospital Emergency Care, Vol. 12, No. 3, pp. 286-289, July 2015. DOI: 10.1080/10903120802100480
  13. MA. Malik, CH. Maharaj, BH. Harte, JG. Laffey, "Comparison of Macintosh, Truview EVO2, Glidescope, and Airwayscope laryngoscope use in patients with cervical spine immobilization," Br J Anaesth, Vol. 101, No. 5, pp. 723-730, November 2008. DOI: 10.1093/bja/aen231
  14. J. Y. Hwang, K. J. Cho, "Comparison of tracheal intubation using the Macintosh laryngoscope versus the intubating laryngeal mask airway in novice users - A manikin study," Korean J Emerg Med Ser Vol. 16, No. 2, pp. 75-89, August 2012. DOI: https://doi.org/10.14408/KJEMS.2018.22.3.035
  15. J. S. Kim, U. J. Choi, "Memory retention of education regarding endotracheal and laryngeal tube intubation -A manikin study," Korean J Emerg Med Ser, Vol. 20, No. 3, pp. 85-93, December 2016. DOI: KMID : 0895520160200030085 https://doi.org/10.14408/KJEMS.2016.20.3.085
  16. J. Brimacombe, C. Keller, "The ProSeal laryngeal mask airway: A randomized, crossover study with the standard laryngeal mask airway in paralyzed, anesthetized patients," Anesthesiology, Vol. 93, No. 1,pp. 104-109, July 2000. DOI: 10.1097/00000542-200007000-00019
  17. K. Linko, M. Paloheimo, T. Tammisto, (1983) "Capnography for detection of accidental esophageal intubation," Acta Anesthesiologica- 43 -Scandinavica 27(3):199-202. DOI: org/10.1111/j.1399-6576.1983.tb01934.x
  18. S. W. Yun, "Comparison of endotracheal intubation speed and ease by using the supraglottic airway laryngopharyngeal tube: a manikin study," J Korean Soc Emerg Med, Vol. 19, No. 2, pp. 29-38, July 2015. DOI: 10.14408/KJEMS.2015.19.2.029
  19. Sebastian. Aleksandrowicz, Marcin. Madziala, "Blind intubation through the supraglottic airway laryngopharyngeal tube with a biohazard suit," Amer J Emerg Med, Vol. 34, No. 10, pp. 2040, October 2016. DOI: 10.1016/j.ajem.2016.07.037
  20. A. Robitaille, SR. Williams, MH. Tremblay, F. Guilbert, M. Theriault, P. Drolet, "Cervical spine motion during tracheal intubation with manual in-line stabilization: direct laryngoscopy versus GlideScopeⓇ videolaryngoscopy," Anesth Analg, Vol. 106, No. 3, pp. 935-941, March 2008. DOI: 10.1213/ane.0b013e318161769e
  21. G. B. Kim, H. J. Choi, H.. C. Shin, "A Clinical analysis and treatment of traumatic cervical spine patients," J Korean Neurosurg Soc, Vol. 28, No. 4, pp. 460-469, July 1999 https://www.jkns.or.kr/journal/view.php?number=3499
  22. Andrzej. Kurowski, Lukasz. Szarpak, Piotr Zasko, Lukasz Bogdanski, Zenon Truszewski, "Comparison of direct intubation and Supraglottic Airway Laryngopharyngeal Tube (S.A.L.T.) for endotracheal intubation during cardiopulmonary resuscitation Randomized manikin study," Via Med J, Vol. 47, No. 3, pp. 195-199, March 2015. DOI: 10.5603/AIT.2015.0031
  23. S. H. Son, S. O. Park, K. J. Baek, P. C. Choi, "Comparison of the macintosh laryngoscope and the disposcope endoscope in both normal airway and manual inline stabilization for suspected cervical spine injury patients: A simulation study using an airway training manikin," J Korean Soc Emerg Med, Vol. 19, No. 1, pp. 45-50, July 2008. DOI: KMID : 0385920110220060628
  24. K. Ruetzler, S. Leung, M. Chmiela, E. Rivas, L. Szarpak, S. Khanna, G. Mao, R. Drake, D. Sessler, "Regurgitation and pulmonary aspiration during cardio-pulmonary resuscitation (CPR) with a laryngeal tube: A pilot crossover human cadaver study," J Plos Blogs, Vol. 14, No. 2, pp. e0212704, February 2019. DOI: 10.1371/journal.pone.0212704