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 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.
Adnet
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Réanimation Toxicologique, Service du Pr. C. Bismuth, Hôpital Fernand Widal, Paris, France.
Lapostolle
F
F
Borron
S W
SW
Hennequin
B
B
Leclercq
G
G
Fleury
M
M
D018592:Cross-Over Studies; D004635:Emergency Medicine / Q000379:methods*; D005931:Glottis; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000379:methods*; D007828:Laryngoscopy / Q000009:adverse effects / Q000379:methods*; D008348:Manikins; D010808:Physical Examination / Q000592:standards*; D016683:Supine Position; D013997:Time Factors; D018677:Tooth Injuries / Q000209:etiology