Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-24T13:30:32.076Z Has data issue: false hasContentIssue false

Insertion of the endotracheal tube, laryngeal mask airway and oesophageal–tracheal Combitube®. A 6-month comparative prospective study of acquisition and retention skills by medical students

Published online by Cambridge University Press:  11 May 2005

N. Weksler
Affiliation:
Ben Gurion University of the Negev, Division of Anesthesiology and Critical Care Medicine, Soroka Medical Center, Faculty of Health Sciences, Beer Sheva, Israel
A. Tarnopolski
Affiliation:
Ben Gurion University of the Negev, Division of Anesthesiology and Critical Care Medicine, Soroka Medical Center, Faculty of Health Sciences, Beer Sheva, Israel
M. Klein
Affiliation:
Ben Gurion University of the Negev, Division of Anesthesiology and Critical Care Medicine, Soroka Medical Center, Faculty of Health Sciences, Beer Sheva, Israel
M. Schily
Affiliation:
Ben Gurion University of the Negev, Division of Anesthesiology and Critical Care Medicine, Soroka Medical Center, Faculty of Health Sciences, Beer Sheva, Israel
V. Rozentsveig
Affiliation:
Ben Gurion University of the Negev, Division of Anesthesiology and Critical Care Medicine, Soroka Medical Center, Faculty of Health Sciences, Beer Sheva, Israel
A. R. Shapira
Affiliation:
Ben Gurion University of the Negev, Division of Anesthesiology and Critical Care Medicine, Soroka Medical Center, Faculty of Health Sciences, Beer Sheva, Israel
G. M. Gurman
Affiliation:
Ben Gurion University of the Negev, Division of Anesthesiology and Critical Care Medicine, Soroka Medical Center, Faculty of Health Sciences, Beer Sheva, Israel
Get access

Extract

Summary

Objective: To assess the ability of medical students to learn and retain skills of airway manipulation for insertion of the endotracheal tube, the laryngeal mask airway (Laryngeal Mask Company, Henley-on-Thames, UK) and the oesophageal–tracheal Combitube® (Kendall-Sheridan Catheter Corp., Argyle, NY, USA).

Methods: A 6-month prospective study was conducted among fifth-year medical students attending a 3-week clerkship in the Division of Anesthesiology and Critical Care Medicine in the Soroka Medical Center. All the students viewed a demonstration of insertion technique for the endotracheal tube, the laryngeal mask airway and the Combitube®, followed by formal teaching in a mannikin. At the end of the program, the insertion skills were demonstrated in the mannikin, the success rate on the first attempt was registered and the students were requested to assess (by questionnaire) their ability to execute airway manipulation (phase 1). Six months later, the students were requested to repeat the insertion technique, and a similar re-evaluation applied (phase 2).

Results: The success rate, during the first phase, at first attempts was 100% for the laryngeal mask airway and the Combitube®, compared to 57.4% for the endotracheal tube (P < 0.02), and 92.6%, 96.2% and 62.9% (P < 0.02) respectively for the second phase of the study.

Conclusion: Learning and retention skills of medical students, in a mannikin, are more accentuated with the laryngeal mask airway and the Combitube® than seen with an endotracheal tube.

Type
Original Article
Copyright
© 2005 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Donegan JH. New concepts in cardiopulmonary resuscitation. Anesth Analg 1981; 60: 100108.Google Scholar
de Latorre F, Robertson C, Chamberlain D, Baskett P. European Resuscitation Council Guidelines 2000 for Adult Advanced Life Support. Resuscitation 2001; 48: 211221.Google Scholar
Nelson MS. Medical student retention of intubation skills. Ann Emerg Med 1989; 18: 10591061.Google Scholar
O'Flaherty D, Adams AP. Endotracheal intubation skills of medical students. J Royal Soc Med 1992; 85: 603604.Google Scholar
Konrad C, Schupfer G, Wietlishbach M, Gerber H. Learning manual skill in anesthesiology: is there a recommended number of cases for anesthetic procedures? Anesth Analg 1998; 86: 635639.Google Scholar
Choyce A, Avidan MS, Patel C, et al. Comparison of laryngeal mask and intubating laryngeal mask insertion by the naïve intubator. Br J Anaesth 2000; 84: 103105.Google Scholar
Davies PR, Tighe SQ, Greenslade GL, Evans GH. Laryngeal mask airway and tracheal tube by unskilled personnel. Lancet 1990; 336: 977979.Google Scholar
Pennant JH, Walker MB. Comparison of the endotracheal tube and laryngeal mask in airway management by paramedic personnel. Anesth Analg 1992; 74: 531534.Google Scholar
Reinhart DJ, Simmons G. Comparison of placement of the laryngeal mask airway with endotracheal tube by paramedics and respiratory therapists. Ann Emerg Med 1994; 24: 260263.Google Scholar
Atherton GL, Johnson JC. Ability of paramedics to use the Combitube in prehospital cardiac arrest. Ann Emerg Med 1993; 22: 12631268.Google Scholar
Alexander R, Hodgson P, Lomax D, Bullen C. A comparison of the laryngeal mask airway and Guedel airway, bag and facemask for manual ventilation following formal training. Anaesthesia 1993; 48: 231234.Google Scholar
Tolley PM, Watts AD, Hickman JA. Comparison of the use of laryngeal mask and facemask by inexperienced personnel. Br J Anaesth 1992; 69: 320321.Google Scholar
Martin PD, Cyna AM, Hunter WAH, Henry J, Ramayya GP. Training nursing staff in airway management for resuscitation. A clinical comparison of the facemask and laryngeal mask. Anaesthesia 1993; 48: 3337.Google Scholar
Oczenski W, Krenn H, Dahaba AA, et al. Complications following the use of the Combitube, tracheal tube and laryngeal mask airway. Anaesthesia 1999; 54: 11611165.Google Scholar
Oczenski W, Krenn H, Dahaba AA, et al. Hemodynamic and catecholamine stress responses to insertion of Combitube, laryngeal mask airway or tracheal intubation. Anesth Analg 1999; 88: 13891394.Google Scholar
Richards CF. Piriform sinus perforation during esophageal–tracheal Combitube placement. J Emerg Med 1998; 17: 3739.Google Scholar
Vezina D, Lessard MR, Bussieres J, Topping C, Trepanier CA. Complications associated with the use of the esophageal–tracheal Combitube. Can J Anaesth 1998; 45: 7680.Google Scholar
Tagnigawa K, Shigematsu A. Choice of airway devices for 12,020 cases of nontraumatic cardiac arrest in Japan. Prehosp Emerg Care 1998; 2: 96100.Google Scholar
Roberts I, Allsop P, Dickinson M, Curry P, Eastwick-Field P, Eyre G. Airway management training using the laryngeal mask airway: a comparison of two different training programmes. Resuscitation 1997; 33: 211214.Google Scholar