The quality of cardiopulmonary resuscitation using supraglottic airways and intraosseous devices: a simulation trial.
OBJECTIVE
To assess whether using interventions such as laryngeal mask airways (LMA) and IO lines lead to improved resuscitation in a simulated cardiac arrest when compared to standard methods of endotracheal intubation (ETI) and central line placement.


METHODS
Emergency Medicine residents at a single academic center were grouped into teams of four. Each team participated in two simulated ventricular fibrillation cardiac arrests using a high fidelity simulator. Peripheral IV access was unobtainable. Only ETI supplies and a central line kit were available in one case (control) and in the other case those supplies were replaced by an LMA and an EZ-IO drill kit (experimental). Groups were randomized to which set up they were given first. Data examined included time to airway placement, duration and success rate of airway placement, time to vascular access, time to defibrillation, and percent hands off time.


RESULTS
44 residents in 11 teams participated. Mean time to airway was shorter in the experimental group (122.8 seconds (s) vs. 265.6 s, p=0.001). Mean duration of airway attempt was also shorter (7.6 s vs. 22.7 s, p=0.002). Time to access was shorter in the experimental group (49.0 s vs. 194.6 s, p=<0.001). Time to defibrillation and percent hands off time did not significantly differ between the two groups.


CONCLUSIONS
Use of an LMA and an IO device led to significantly faster establishment of an airway and vascular access in a simulated cardiac arrest. The variation in devices did not affect time to defibrillation or percent hands off time.
Department of Emergency Medicine, Mount Sinai School of Medicine, New York, NY, United States. dena.asaad@gmail.com
Dena A
DA
Reiter
Christopher G
CG
Strother
Scott D
SD
Weingart
D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation*; D018592:Cross-Over Studies; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D004635:Emergency Medicine / Q000193:education*; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D017148:Infusions, Intraosseous / Q000295:instrumentation*; D017214:Laryngeal Masks; D008348:Manikins; D010348:Patient Care Team; D013997:Time Factors