title: Cuffed oropharyngeal airway (COPA) placement is delayed by wearing antichemical protective gear.
abstract: BACKGROUND
  Airway management, the first step in resuscitation, may entail special difficulties in mass casualty situations, even in experienced hands. Of the available airway devices, the cuffed oropharyngeal airway (COPA) appears the easiest one to insert, allowing a hands-free anaesthesiologist. A study was undertaken to evaluate the success of airway control with COPA when anaesthetists wore either surgical attire or antichemical protective gear.
  
  
  METHODS
  Twelve anaesthetists with 2-5 years of residency inserted COPA in 24 anaesthetised patients in a random crossover prospective manner. The duration of airway management was measured from the time the device was grasped to obtaining a normal capnography recording; time to proper fixation was also recorded.
  
  
  RESULTS
  Time to COPA placement was significantly shorter when the anaesthetists wore surgical attire than when they wore protective gear (28 (10) s vs 56 (34) s, p<0.05). Time to proper fixation of the COPA to patients' faces also differed significantly (19 (14) s with surgical attire vs 34 (16) s with protective gear, p<0.05). First-time COPA insertion failure was statistically similar in both groups. There was no hypoxaemia.
  
  
  CONCLUSIONS
  Antichemical protective gear slowed proper placement of COPA and its fixation compared with surgical attire. COPA may be a temporarily useful device in non-conventional settings, but functional reassessment is required when injured patients reach medical facilities.
authors.affiliation: Department of Anesthesia and CCM, Tel Aviv Sourasky Medical Centre, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: R
authors.initials: R
authors.lastname: Ben-Abraham
authors.forename: R
authors.initials: R
authors.lastname: Flaishon
authors.forename: A
authors.initials: A
authors.lastname: Sotman
authors.forename: T
authors.initials: T
authors.lastname: Ezri
authors.forename: M
authors.initials: M
authors.lastname: Weissenberg
authors.forename: A A
authors.initials: AA
authors.lastname: Weinbroum
mesh_terms: D000776:Anesthesiology; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D008297:Male; D008875:Middle Aged; D009960:Oropharynx; D011481:Protective Clothing; D013997:Time Factors