What is the optimal position of an intubator wearing CBRN-PPE when intubating on the floor: A manikin study

Resuscitation

Volumn 82, Issue 5, 2011, Pages 588-592

  Castle, Nick ^a,b   Pillay, Yugan ^a,b,c   Spencer, Neil ^d  

^a FRIMLEY PARK HOSPITAL   (United Kingdom)

^b DURBAN UNIVERSITY OF TECHNOLOGY   (South Africa)

^c Education and Research Qatar EMS   (Qatar)

^d UNIVERSITY OF HERTFORDSHIRE   (United Kingdom)

Author keywords

CBRN; Intubation

Indexed keywords

AIRWAY; AMBULANCE; ARTICLE; BODY POSITION; CLOTHING; CONTROLLED STUDY; DEVICE; HUMAN; INTUBATION; NORMAL HUMAN; PARAMEDICAL PROFESSION; PARAMEDICAL STUDENT; PATIENT; PERFORMANCE; PRIORITY JOURNAL; PROTECTIVE EQUIPMENT; RECUMBENCY; SAFETY; SITTING; SKILL;

ACCIDENTS; AIRWAY OBSTRUCTION; CROSS-OVER STUDIES; HEART ARREST; HUMANS; INTUBATION, INTRATRACHEAL; MANIKINS; PATIENT POSITIONING; PROTECTIVE DEVICES; RESPIRATORY INSUFFICIENCY;

EID: 79955109656     PISSN: 03009572     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.resuscitation.2011.01.005     Document Type: Article

References (27)

1. Muskat P.C. Mass casualty chemical exposure and implications for respiratory failure. Respir Care 2008, 53:58-66.
2. Baker D.J. Management of respiratory failure in toxic disasters. Resuscitation 1999, 42:131-135.
3. Okumura T., Takasu N., Ishimatsu S., et al. Report on 640 victims of the Tokyo subway sarin attack. Ann Emerg Med 1996, 28:129-136.
4. Wax P.M., Becker C.E., Curry S.C. Unexpected 'gas' casualties in Moscow: a medical toxicology perspective. Ann Emerg Med 2003, 41:700-705.
5. Schiermeier Q. Hostage deaths put gas weapons in spotlight. Nature 2002, 420:7.
6. Doran J.V., Tortella B.J., Drivet W.J., Lavery R. Factors influencing successful intubation in the prehospital setting. Prehosp Disaster Med 1995, 10:258-264.
7. Garza A.G., Gratton M.C., McElroy J., et al. Environmental factors encountered during out-of-hospital intubation attempts. Prehosp Emerg Care 2008, 12:286-289.
8. Castle N., Owen R., Clarke S., Hann M., Reeves D., Gurney I. Does position of the patient adversely affect successful intubation whilst wearing CBRN-PPE?. Resuscitation 2010, 81:1165-1171.
9. Castle N., Owen R., Clarke S., Hann M., Reeves D., Gurney I. Impact of chemical, biological radiation and nuclear personnel protective equipment on the performance of low- and high-dexterity airway and vascular skills. Resuscitation 2009, 80:1290-1295.
10. Flaishon R., Sotman A., Ben-Abraham R., Rudick V., Varssano D., Weinbroum A.A. Antichemical protective gear prolongs time to successful airway management. Anaesthesiology 2004, 100:260-266.
11. Hoyle J.D., Jones J.S., Deibel M., et al. Comparative study of airway management techniques with restricted access to patient airway. Prehosp Emerg Care 2007, 11:330-336.
12. Blakeman T., Toth P., Rodriquez D., Branson R. Mechanical ventilators in the hot zone: effects of a CBRN filter on patient protection and battery life. Resuscitation 2010, 81:1148-1151.
13. Brinker A., Stratling W., Schumacher J. Evaluation of bag-valve-mask ventilation in simulated toxic environment. Anaesthesia 2008, 63:1234-1237.
14. Birkinshaw R., McKinnon K.A., Kitching G., Ryan B. Intubation in difficult positions. Pre-hospital Immediate Care 1998, 2:59-62.
15. Koetter K., Hilker T., Genzwuerker H., et al. A randomized comparison of rescuer positions for intubation on the ground. Prehosp Emerg Care 1997, 1:96-99.
16. Nolan J.P., Deakin C.D., Soar J., et al. European Resuscitation Council guidelines for resuscitation 2005. Section 4. Adult advanced life support. Resuscitation 2005, 67(Suppl. 1):S39-S86.
17. Goldstein H. Multilevel statistical models 2003, Arnold Publishers, London.
18. Castle N., Owen R., Clarke S., et al. Are prehospital clinicians faster at intubation on the floor whilst wearing CBRN-PPE than hospital clinicians?. Intensive Care Med 2010, 36:S302.
19. Yang J.H., Kim Y.M., Chung H.S., et al. Comparison of four manikins and fresh frozen cadaver models for direct laryngoscopic orotracheal intubation training. Emerg Med J 2010, 27:13-16.
20. Al-Damouk M., Bleetman A. Impact of the Department of Health initiative to equip and train acute trusts to manage chemically contaminated casualties. Emerg Med J 2005, 22:347-350.
21. Brinker A., Gray S.A., Schumacher J. Influence of air-purifying respirators on the simulated first response emergency treatment of CBRN victims. Resuscitation 2007, 74:310-316.
22. Helm M., Hossfeld B., Schafer S., et al. Factors influencing emergency intubation in the prehospital settings-a multicentre study in the German Helicopter Emergency Medical Service. Br J Aanesth 2006, 96:67-71.
23. Adnet F., Cydulka R.K., Lapandry C. Emergency tracheal intubation of patients lying supine on the ground: influence of operator body position. Can J Anaesth 1998, 45:266-269.
24. Timmermann A., Russo S., Eich C., et al. The out-of-hospital esophageal and endobronchial intubation performed by emergency physicians. Anesth Analg 2007, 104:619-623.
25. Lyon R.M., Ferris J.D., Young D.M., et al. Field intubation of cardiac arrest patients: a dying art. Emerg Med J 2010, 27:321-323.
26. Baskett P.J.F., Bossaert L., Carli P., et al. Guidelines for the advanced management of the airway and ventilation during resuscitation. Resuscitation 1996, 31:201-230.
27. Talbot T.S., Cuena P.J., Wedmore I.S. Intubating laryngeal mask airway verses laryngoscope and endotracheal intubation in the nuclear, biological, and chemical environment. Mil Med 2003, 168:876-879.