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Competence in the use of supraglottic airways by Australian surf lifesavers for cardiac arrest ventilation in a manikin
Author(s) -
HolberyMorgan Lachlan,
Angel Cara,
Murphy Michelle,
Carew James,
Douglas Finn,
Murphy Robert,
Hood Natalie,
Rechtman Andrew,
Scarff Christopher,
Simpson Nicholas,
Stewardson Andrew,
Steinfort Daniel,
Radford Sam,
Douglas Ned,
Johnson Douglas
Publication year - 2017
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.12719
Subject(s) - medicine , cardiopulmonary resuscitation , ventilation (architecture) , supraglottic airway , anesthesia , airway , airway management , resuscitation , mechanical engineering , engineering
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.