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Comparison of Intubation Success Rate and Times Required for Intubation by Glottic Exposure Methods with Glidescope(R)
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Hyung Seo Jang, Jun Bum Park, Jae Hoon Oh, Chang Sun Kim, Hyuk Joong Choi, Bo Seung Kang, Tae Ho Lim, Hyung Goo Kang
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Korean J Crit Care Med. 2013;28(4):241-246.
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DOI: https://doi.org/10.4266/kjccm.2013.28.4.241
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Abstract
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The glottis can be exposed by a Glidescope(R) during endotracheal intubation using either the epiglottis or valleculae elevation method. We compared the epiglottis and valleculae elevation methods for endotracheal intubations performed with a Glidescope(R) using differences in success rate, time spent for tracheal intubation and percent of glottic opening. METHODS Forty medical students without experience using a Glidescope(R) participated in this prospective, randomized study in which they intubated a tracheal tube into a manikin. All participants performed tracheal intubation using the 2 forementioned methods. Twenty students exposed the vocal cord by placing the blade tip in the valleculae (valleculae elevation method; VEM). The other 20 students directly elevated the epiglottis with the blade (epiglottis elevation method; EEM). We separated intubating time into 3 parts: turnaround time to exposing the vocal cord, tube passing time and first ventilating time. RESULTS The success rate of tracheal intubation using VEM (86.7%, 104/120) was higher than that using EEM (65.8%, 79/120) (p < 0.001). VEM resulted in a lower total intubation time (VEM vs. EEM, 23.5 +/- 5.3 vs. 29.0 +/- 8.7, p = 0.001). The key factor of this difference was the tube passing time (VEM vs. EEM, 7.4 +/- 2.5 vs. 12.8 +/- 7.4, p < 0.001). CONCLUSIONS Exposing the vocal cord by using VEM during tracheal intubation with a Glidescope(R) can increase the success rate of tracheal intubation and shorten the time of endotracheal intubation in novices.
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Comparison of Cervical Spine Movement by Airway Equipment during Orotracheal Intubation: A Manikin Pilot Study
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Sang Hyun Lee, Hyuk Choong Choi, Hyung Goo Kang, Bo Seung Kang, Tai Ho Lim
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Korean J Crit Care Med. 2010;25(4):230-234.
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DOI: https://doi.org/10.4266/kjccm.2010.25.4.230
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Abstract
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In patients with limited cervical spine movement, equipment for orotracheal intubation should achieve sufficient laryngeal exposure with the least cervical spine movement. This study was designed to compare movement of the cervical spine during the orotracheal intubation with various intubating equipment. METHODS Twelve emergency physicians & residents with a total experience of >50 cases of endotracheal intubation in two emergency centers were assigned to perform orotracheal intubation with four different airway devices, including the Macintosh laryngoscope (ML), DCI video laryngoscope (DCI), Airway Scope (AWS) and Levitan Scope (LS), using the same manikin (Ambu(R) airway management trainer) in random sequences. Movement of the C-spine was examined by measuring the angle formed by two lines which are parallel to the anterior surface of the C2 and C7 vertebrae bodies. The angle was measured when Cormack-Lehane grade II glottis exposure was achieved during intubation. RESULTS Mean cervical spine movements were 37.6 +/- 9.2degrees, 32.2 +/- 14.2degrees, 32.2 +/- 6.45degrees and 17.4 +/- 10.0degrees with the ML, DCI (p = 0.347), AWS (p = 0.094), and LS (p < 0.001), respectively, compared to that of ML. Cervical spine movement by LS was 54% less than that by ML. LS produced less cervical spine movement in comparison to DCI (p = 0.013) and AWS (p = 0.001). CONCLUSIONS The Levitan Scope produced less movement of the cervical spine when compared to the Macintosh laryngoscope, DCI video-laryngoscope and Airway Scope during orotracheal intubation in a single airway training manikin model.
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Development of Assessment Tools for Performance and Leadership of a Cardiopulmonary Resuscitation Team
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Sung Pil Chung, Junho Cho, Yoo Seok Park, Hyung Goo Kang, Seung Whan Kim, Chan Woong Kim, Yoo Sang Yoon, Keun Jeong Song, Hoon Lim, Gyu Chong Cho, Young Hwan Choi
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Korean J Crit Care Med. 2009;24(2):64-68.
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DOI: https://doi.org/10.4266/kjccm.2009.24.2.64
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Abstract
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The assessment tools for leadership and performance of resuscitation teams are have not been developed. We evaluated the checklists for resuscitation team performance and teamwork. METHODS We developed two checklists for team dynamics (D1, D2) and two checklists for team performances (P1, P2). The videotaped mock resuscitation before and after a 2-hr Advanced Cardiovascular Life Support (ACLS) training were also evaluated by two emergency physicians and two nurses using the four checklists. The validity and agreement between assessors were determined. Internal consistency was determined using Cronbach-alpha. RESULTS There were no significant differences in scores by expert consensus and the checklist score. The average scores between different assessors were different except for the D1 and D2 between doctors. The Cronbach-alpha for internal consistency were within acceptable ranges in the checklists D2 and P2. CONCLUSIONS This study suggests that the D2 and P2 checklists are provisionally acceptable due to relatively high validity, agreement, and internal consistency. However, further research is needed to develop validated checklists for resuscitation teams.
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Citations
Citations to this article as recorded by
- Effects of communication team training on clinical competence in Korean Advanced Life Support: A randomized controlled trial
Soyeon Yun, Hyeoun‐Ae Park, Sang‐Hoon Na, Hee Je Yun Nursing & Health Sciences.2024;[Epub] CrossRef - Focused and Corrective Feedback Versus Structured and Supported Debriefing in a Simulation-Based Cardiac Arrest Team Training
Ji-Hoon Kim, Young-Min Kim, Seong Heui Park, Eun A Ju, Se Min Choi, Tai Yong Hong Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare.2017; 12(3): 157. CrossRef - Nurses' Cardiopulmonary Resuscitation Performance during the First 5 minutes in In-Situ Simulated Cardiac Arrest
Eun Jung Kim, Kyeong Ryong Lee, Myung Hyun Lee, Jiyoung Kim Journal of Korean Academy of Nursing.2012; 42(3): 361. CrossRef - Assessment and Training of Teamwork and Leadership for Critical Care Nurses: A Pilot Study
Hyun Jin Kim, Sang Mo Je, Hyun Soo Chung, Sung Phil Chung, Hahn Shick Lee Korean Journal of Critical Care Medicine.2012; 27(2): 75. CrossRef
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Comparison of Impedance Cardiography with Thermodilution of Hemodynamic Parameters in Critically Ill Patients
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Hyung Goo Kang, Sang Won Chung, Ki Hyun Byun, In Byung Kim
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Korean J Crit Care Med. 2006;21(2):77-82.
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Abstract
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To evaluate the feasibility of noninvasive hemodynamic monitoring (impedance cardiography, ICG) in critically ill patients, we compared this technique with simultaneous invasive monitoring with a pulmonary artery thermodilution catheter. METHODS A prospective observational study was done comparing invasive monitoring and noninvasive monitoring in 12 critically ill patients. The cardiac output (CO), the stroke volume (SV) and the systemic vascular resistance (SVR) measured by using a standard thermodilution pulmonary artery catheter technique were compared with the corresponding measurements simultaneously using an ICG. RESULTS The value of CO, SV and SVR measured by ICG were closely correlated to those by the thermodilution methods [r: 0.659 (p<0.01), 0.536 (p<0.01), 0.738 (p<0.01)]. CONCLUSIONS ICG can provide hemodynamic information previously available only by invasive monitoring with a thermodilution catheter.
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