Using a laryngeal tube during cardiac arrest reduces "no flow time" in a manikin study: a comparison between laryngeal tube and endotracheal tube.
In 2005 the European Resuscitation Council published new guidelines for advanced life support. One of the issues was to reduce the "no flow time", which is defined as the time without chest compression in the first period of cardiac arrest. In a manikin study, we evaluated whether using the laryngeal tube instead of endotracheal intubation for airway management during cardiac arrest could reduce the "no flow time".


METHODS
The study was prospective and included 50 volunteers who performed standardized management of simulated cardiac arrest in a manikin. All participants had completed an obligatory course in emergency medicine but had not been specifically trained in endotracheal intubation; they were therefore designated as unfamiliar in using the endotracheal tube to secure the airway, in accordance with the definition of the European Resuscitation Council. We defined two groups for the study: the LT group, who used the laryngeal tube to secure the airway; and the ET group, who used the endotracheal tube and bag-mask ventilation to ventilate the manikin. The participants were initially randomly assigned to one of the groups and thereafter completed the other scenario. Study endpoints were the total "no flow time" and adherence to guidelines of the European Resuscitation Council.


RESULTS
Use of the laryngeal tube during cardiac arrest in the manikin significantly reduced the "no flow time" when compared with endotracheal intubation (109.3 s vs. 190.4 s; P < 0.01). The laryngeal tube was inserted significantly faster than the endotracheal tube (13 s vs. 52 s; P < 0.01) and was correctly positioned by 98% of the participants at the first attempt, compared with 72% using the endotracheal tube.


CONCLUSIONS
With regard to the guidelines of the European Resuscitation Council, we are convinced that during cardiac arrest supraglottic airway devices should be used by emergency personnel unfamiliar with endotracheal intubation.
Wiese
Christoph H R
CH
Department of Anesthesiology, Emergency and Intensive Care Medicine, University Medical Center Göttingen, Germany. cwiese@zari.de
Bartels
Utz
U
Bergmann
Anna
A
Bergmann
Ingo
I
Bahr
Jan
J
Graf
Bernhard M
BM
D000328:Adult; D001317:Austria; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation*; D004632:Emergency Medical Services; D004867:Equipment Design; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D008297:Male; D008348:Manikins; D008875:Middle Aged; D013996:Time and Motion Studies