Comparison of i-Gel as a Conduit for Intubation between under Fiberoptic Guidance and Blind Endotracheal Intubation during Cardiopulmonary Resuscitation: A Randomized Simulation Study.

PURPOSE: This study aimed to compare intubation performances among i-gel blind intubation (IGI), i-gel bronchoscopic intubation (IBRI), and intubation using Macintosh laryngoscope (MCL) applying two kinds of endotracheal tube during chest compressions. We hypothesized that IGI using wire-reinforced silicone (WRS) tube could achieve endotracheal intubation most rapidly and successfully. METHODS: In 23 emergency physicians, a prospective randomized crossover manikin study was conducted to examine the three intubation techniques using two kinds of endotracheal tubes. The primary outcome was the intubation time. The secondary outcome was the cumulative success rate for each intubation technique. A significant difference was considered when identifying p < 0.05 between two devices or p < 0.017 in post hoc analysis of the comparison among three devices. RESULTS: The mean intubation time using IGI was shorter (p < 0.017) than that of using IBRI and MCL in both endotracheal tubes (17.6 vs. 29.3 vs. 20.2 in conventional polyvinyl chloride (PVC) tube; 14.6 vs. 27.4 vs. 19.9 in WRS tube; sec). There were no significant (p < 0.05) differences between PVC and WRS tubes for each intubation technique. The intubation time to reach 100% cumulative success rate was also shorter in IGI (p < 0.017) than that in IBRI and MCL in both PVC and WRS tubes. CONCLUSIONS: IGI was an equally successful and faster technique compared with IBRI or MCL regardless of the use of PVC or WRS tube. IGI might be an appropriate technique for emergent intubation by experienced intubators during chest compressions.

Comparison of Leukosan SkinLink with surgical suture for traumatic laceration repair: A randomized controlled trial.

BACKGROUND: Leukosan SkinLink (LS), which combines non-woven textile strips and tissue adhesive, offers the advantage of atraumatic treatment while effectively shortening the procedure time. We hypothesized that wound closure would be faster with LS than with surgical suture (SS) and the wound infection and dehiscence would be similar. METHODS: A prospective, open label, single-center, randomized controlled trial was performed. Between November 2014 and April 2016, 49 patients with traumatic lacerations who presented to the emergency department were eligible for study inclusion. RESULTS: The mean wound closure time was significantly lower in the LS group than in the SS group (1.48 ±â€Š0.2 seconds vs 8.8 ±â€Š3.6 minutes, P < .001). After adjusting the wound closure time according to the lacerations length, the time remained significantly lower in the LS group than in the SS group (1.0 ±â€Š0.8 seconds vs 5.03 ±â€Š2.5minutes, P < .001). During follow-up for 14 days, no significant differences in dehiscence and wound infection were observed between the 2 groups. CONCLUSION: Wound closure was approximately 4minutes faster with LS and there were no differences in wound infection and dehiscence rates. Thus, the LS could be used as a timesaving suture technique for acute traumatic lacerations in emergency department (ED). TRIAL REGISTRATION: ClinicalTrials.gov NCT02333877.

Pre-hospital i-gel blind intubation for trauma: a simulation study.

OBJECTIVE: This study aimed to evaluate the efficacy of i-gel blind intubation (IGI) as a rescue device for definitive airway management in ground intubation for pre-hospital trauma patients. METHODS: A prospective randomized crossover study was conducted with 18 paramedics to examine intubation performance of two blind intubation techniques through a supraglottic airway devices (IGI and laryngeal mask airway Fastrach), compared with use of a Macintosh laryngoscope (MCL). Each intubation was conducted at two levels of patient positions (ground- and stretcher-level). Primary outcomes were the intubation time and the success rate for intubation. RESULTS: The intubation time (sec) of each intubation technique was not significantly different between the two positions. In both patient positions, the intubation time of IGI was shortest among the three intubation techniques (17.9±5.2 at the ground-level and 16.9±3.8 at the stretcher-level). In the analysis of cumulative success rate and intubation time, IGI was the fastest to reach 100% success among the three intubation techniques regardless of patient position (all P<0.017). The success of intubation was only affected by the intubation technique, and IGI achieved more success than MCL (odds ratio, 3.6; 95% confidence interval, 1.1 to 11.6; P=0.03). CONCLUSION: The patient position did not affect intubation performance. Additionally, the intubation time with blind intubation through supraglottic airway devices, especially with IGI, was significantly shorter than that with MCL.

Comparison of blind intubation through supraglottic devices and direct laryngoscopy by novices: a simulation manikin study.

OBJECTIVE: This study aimed to compare intubation performance between blind intubation through supraglottic airway devices and direct laryngoscopy by novices under manikin simulation. We hypothesized that the intubation time by novices using supraglottic airway devices was superior to that with the Macintosh laryngoscope (MCL). METHODS: A prospective, randomized crossover study was conducted with 95 participants, to evaluate i-gel, air-Q, LMA Fastrach, and MCL devices. Primary outcomes were the intubation time and the success rate for intubation. RESULTS: The i-gel showed the shortest insertion and tube passing time among the four devices; the i-gel and air-Q also showed the shortest total intubation time (all P<0.0083; i-gel vs. air-Q, P=0.03). The i-gel and MCL showed the highest cumulative success rate (all P<0.0083; i-gel vs. MCL, P=0.12). CONCLUSION: Blind intubation through the i-gel showed almost equal intubation performance compared to direct laryngoscopy.