| Does an advanced life support course give non-anaesthetists adequate skills to manage an airway? | |
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MedLine Citation:
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PMID: 20189705 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Traditionally, anaesthetists have provided airway management skills on resuscitation teams. Because advanced life support (ALS) courses teach practical airway management, some UK hospitals have dropped anaesthetists from cardiac arrest teams. Does the ALS course give non-anaesthetists adequate skills to manage an airway during a cardiac arrest? METHODS: We recruited adult surgical patients undergoing general anaesthesia and laryngeal mask airway (LMA) insertion as part of their routine care. Patients were randomly assigned to airway management by a junior doctor; either an ALS-qualified anaesthetist or an ALS-qualified non-anaesthetist. After induction of anaesthesia, five manual ventilations were delivered using a self-inflating bag-mask device before insertion of a LMA. We recorded the quality of manual ventilation (adequate, partially adequate or inadequate), the time to LMA insertion, and any complications. RESULTS: Twenty anaesthetists and 16 non-anaesthetist ALS graduates participated. Of the anaesthetists, 18 (90%) demonstrated adequate and 2 (10%) demonstrated partially adequate manual ventilation skills, compared with non-anaesthetists of whom 5 (31.25%) demonstrated adequate, 5 (31.25%) demonstrated partially adequate, and 6 (37.5%) demonstrated inadequate manual ventilation skills (p<0.001). Eighteen anaesthetists (90%) and 4 non-anaesthetists (25%) met the ALS LMA insertion guideline time of 30s (p<0.0001). Median time for LMA insertion by anaesthetists and non-anaesthetists was 20.5s (range 16-40s, n=20) and 35.0 s (range 18-168, n=10) respectively (p<0.05). Six of the 16 non-anaesthetists failed to insert the LMA (37.5%). There were four complications (laryngospasm, vomiting, and SaO(2)<90%) in the non-anaesthetic group (25% of patients), compared with none in the anaesthetic group (p=0.01). CONCLUSIONS: The airway component of an ALS course alone does not give adequate practical skills for non-anaesthetists to manage an airway in an anaesthetised patient. Airway management at a cardiac arrest is unlikely to be any better. |
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Authors:
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Charles D Deakin; David Murphy; Michael Couzins; Stephen Mason |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2010-03-01 |
Journal Detail:
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Title: Resuscitation Volume: 81 ISSN: 1873-1570 ISO Abbreviation: Resuscitation Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-04-19 Completed Date: 2010-08-12 Revised Date: 2010-11-22 |
Medline Journal Info:
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Nlm Unique ID: 0332173 Medline TA: Resuscitation Country: Ireland |
Other Details:
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Languages: eng Pagination: 539-43 Citation Subset: IM |
Copyright Information:
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Copyright 2010 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Shackleton Department of Anaesthetics, Southampton University Hospital NHS Trust, Tremona Road, Southampton SO16 6YD, UK. charlesdeakin@doctors.org.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Anesthesia Anesthesiology* Clinical Competence* Humans Laryngeal Masks Life Support Care* Process Assessment (Health Care)* Respiration, Artificial Respiratory System Specialization* Time Factors Young Adult |
| Comments/Corrections | |
Comment In:
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Resuscitation. 2010 Nov;81(11):1592
[PMID:
20846777
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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