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An endotracheal tube mounted camera for intubation during cardiopulmonary resuscitation. Preliminary data

Published:February 04, 2018DOI:https://doi.org/10.1016/j.ajem.2018.01.091
      Tracheal intubation in emergency medicine is considered one of the most difficult procedures [
      • Szarpak Ł.
      • Czyżewski Ł.
      • Kurowski A.
      • Truszewski Z.
      Comparison of the TruView PCD video laryngoscope and Macintosh laryngoscope for pediatric tracheal intubation by novice paramedics: a randomized crossover simulation trial.
      ,
      • Smereka J.
      • Ladny J.R.
      • Naylor A.
      • Ruetzler K.
      • Szarpak L.
      C-MAC compared with direct laryngoscopy for intubation in patients with cervical spine immobilization: a manikin trial.
      ]. Due to the inability to obtain anesthesia anamnesis or as in the case of cardiopulmonary resuscitation, the need to protect the airway during chest compression or with a minimum pause in chest compression. However, according to studies by Ladny et al. [
      • Ladny J.R.
      • Smereka J.
      • Szarpak L.
      Comparison of the Trachway video intubating stylet and Macintosh laryngoscope for endotracheal intubation. Preliminary data.
      ,
      • Ladny J.R.
      • Sierzantowicz R.
      • Kedziora J.
      • Szarpak L.
      Comparison of direct and optical laryngoscopy during simulated cardiopulmonary resuscitation.
      ], or Szarpak et al. [
      • Szarpak L.
      • Truszewski Z.
      • Czyzewski L.
      • Gaszynski T.
      • Rodríguez-Núñez A.
      A comparison of the McGrath-MAC and Macintosh laryngoscopes for child tracheal intubation during resuscitation by paramedics. A randomized, crossover, manikin study.
      ], the effectiveness of the first intubation attempt using direct laryngoscopy is insufficient. In accordance with the European Resuscitation Council guidelines, endotracheal intubation is the gold standard in airway management [
      • Smereka J.
      • Ladny J.R.
      • Naylor A.
      • Ruetzler K.
      • Szarpak L.
      C-MAC compared with direct laryngoscopy for intubation in patients with cervical spine immobilization: a manikin trial.
      ]. It allows to minimize breaks in chest compression and thus increases the chances of survival of the patients with cardiac arrest. One of the latest new endotracheal intubation techniques is intubation using endotracheal tube with integrated camera - ETView SL (ETView, VivaSight Ltd., Misgav, Israel). Yu et al. [
      • Yu H.
      • Zuo M.Z.
      Use of the ETView tracheoscopic ventilation tube in airway management of a patient with unanticipated difficult bag-mask ventilation.
      ] used ETView for the airway management and ventilation in the event of inability to ventilate patients using a bag-mask ventilation. In turn Barak et al. [
      • Barak M.
      • Putilov V.
      • Meretyk S.
      • Halachmi S.
      ETView tracheoscopic ventilation tube for surveillance after tube position in patients undergoing percutaneous nephrolithotomy.
      ], used ETView SL for surveillance after tube position in patients undergoing percutaneous nephrolithotomy. However, there are a limited number of studies on the use of ETView in emergency medicine. The aim of the study was to evaluate the effectiveness of intubation using various intubation techniques in simulated adult cardiopulmonary resuscitation conditions, moreover the primary outcome was the effectiveness of the first endotracheal intubation attempt.
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