Feasibility of the video-laryngoscope (GlideScope?) for endotracheal intubation during uninterrupted chest compressions in actual advanced life support: A clinical observational study in an urban emergency department

摘要

Aim: This is the first clinical trial to evaluate whether successful endotracheal intubation (ETI) using a video-laryngoscope (VL) (GlideScope?) can be performed easily without chest compression interruptions during actual cardiopulmonary resuscitation (CPR) after brief VL training, regardless of the physicians' levels of experience with successful ETI in the past. Methods: We performed a prospective, clinical observation study. After completing a brief 1-h VL training, 14 emergency physicians intubated arrest victims using a VL during CPR in the emergency department for a period of 1 year. All CPRs were recorded by video and were reviewed retrospectively. Outcomes were based on the success rate of the first ETI attempt, the time until the first successful ETI attempt (TUS) and chest compression interruptions during ETI. The outcomes were compared based on the physicians' varying experience with successful ETI in the past. Results: Of 71 CPRs, all cases were successful and 66 cases (93%) were successful at the first ETI attempt with no significant chest compression interruptions. The median TUS was 41.5 (33.8, 61.2) s. There were no differences between less and more experienced physicians in the success rate of the first ETI attempts (97.3% vs. 88.2%; p= 0.187), or the median TUS (41.5 (33.5, 58.0) vs. 42.0 (33.8, 64.3) s; p= 0.842). Conclusions: In a clinical setting, the use of a VL had a high success rate for the first ETI attempt with notably few chest compression interruptions, regardless of the physicians' varying experience with successful ETI in the past.