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Title: Competence in the use of supraglottic airways by Australian surf lifesavers for cardiac arrest ventilation in a manikin
Austin Authors: Holbery-Morgan, Lachlan;Angel, Cara;Murphy, Michelle;Carew, James;Douglas, Finn;Murphy, Robert;Hood, Natalie;Rechtman, Andrew;Scarff, Christopher;Simpson, Nicholas;Stewardson, Andrew J;Steinfort, Daniel;Radford, Samuel T ;Douglas, Ned;Johnson, Douglas F
Affiliation: Life Saving Victoria, Melbourne, Victoria, Australia
Ambulance Victoria, Melbourne, Victoria, Australia
School of Medicine, Deakin University, Melbourne, Victoria, Australia
Surf Life Saving Australia, Sydney, New South Wales, Australia
Emergency Department, Monash Medical Centre, Melbourne, Victoria, Australia
Department of Paediatrics, Albury Base Hospital, Albury, New South Wales, Australia
Department of Anaesthesia, St Vincent's Hospital, Melbourne, Victoria, Australia
Intensive Care Unit, University Hospital Geelong, Geelong, Victoria, Australia
Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
Department of Respiratory Medicine, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
Intensive Care Unit, Austin Health, Heidelberg, Victoria, Australia
Department of Anaesthesia and Pain Management, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
Department of General Medicine, Austin Health, Heidelberg, Victoria, Australia
Issue Date: Feb-2017 2017-01-11
Publication information: Emergency Medicine Australasia : EMA 2017; 29(1): 63-68
Abstract: OBJECTIVES: Lifesavers in Australia are taught to use pocket mask (PM) rescue breathing and bag valve mask (BVM) ventilation, despite evidence that first responders might struggle with these devices. Novices have successfully used the Laryngeal Mask Airway (LMA) Supreme and iGel devices previously, but there has been no previous comparison of the ability to train lifesavers to use the supraglottic airways compared to standard techniques for cardiac arrest ventilation. METHODS: The study is a prospective educational intervention whereby 113 lifesavers were trained to use the LMA and iGel supraglottic airways. Comparisons were made to standard devices on plastic manikins. Successful ventilation was defined as achieving visible chest rise. RESULTS: The median time to first effective ventilation was similar between the PM (16 s, 95% confidence interval 16-17 s), BVM (17 s, 16-17 s) and iGel devices (18 s, 16-20 s), but longer for the LMA (36 s, 33-38 s). The iGel frequently failed to achieve ventilation (10%) compared with the PM (1%, P < 0.01) and LMA (3%, P < 0.01) but was not worse than the BVM (3%, P < 0.57). Hands-off time was similar between the BVM, LMA and iGel (10 s for each device), but worse for the PM (13 s, P = 0.001). CONCLUSION: Lifesavers using the PM and BVM perform ventilation for cardiopulmonary resuscitation well. There appears to be a limited role for supraglottic airway devices because of limitations in terms of time to first effective ventilation and reliability. Clinical validation of manikin data with live resuscitation performance is required.
DOI: 10.1111/1742-6723.12719
PubMed URL:
Type: Journal Article
Subjects: Airway management
Cardiac arrest
Supraglottic airway
Appears in Collections:Journal articles

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