Does the use of a bougie reduce the force of laryngoscopy in a difficult airway with manual in-line stabilisation?: a randomised crossover simulation study

Manual in-line stabilisation is usually used during tracheal intubation of trauma patients to minimise movement of the cervical spine and prevent any further neurological injury. Use of a bougie in combination with laryngoscopy may reduce the forces exerted on the cervical spine. To evaluate the dif...

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Published inEuropean journal of anaesthesiology Vol. 30; no. 9; p. 563
Main Authors Hung, Rachel K Y, Lewinsohn, Asher, Jovaisa, Tomas, Wijayatilake, Dhuleep S, Sherren, Peter B
Format Journal Article
LanguageEnglish
Published England 01.09.2013
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Abstract Manual in-line stabilisation is usually used during tracheal intubation of trauma patients to minimise movement of the cervical spine and prevent any further neurological injury. Use of a bougie in combination with laryngoscopy may reduce the forces exerted on the cervical spine. To evaluate the difference in force applied to the head and neck during tracheal intubation with a Macintosh laryngoscope with or without simultaneous use of a bougie. Randomised, crossover simulation study. Simulation laboratory, Anaesthetic Department, Queen's Hospital, Romford between March and April 2012. Twenty anaesthetists, all with a minimum of 1 year of anaesthetic experience. Participants used either a Macintosh laryngoscope alone, or in combination with a bougie in a Laerdal SimMan manikin with a simulated difficult airway and manual in-line stabilisation. The force exerted during laryngoscopy. Success rate and time taken to tracheal intubation were also measured. Significantly less force was exerted utilising a Macintosh laryngoscope in combination with a bougie compared with the laryngoscope alone (24.9 versus 44.5 N; P < 0.001). The trachea was successfully intubated on all occasions within 120 s. The use of a bougie was associated with a nonsignificant reduction in the time to tracheal intubation. To minimise the force of laryngoscopy and movement of a potentially unstable cervical spine injury, consideration should be given to the early use of a bougie.
AbstractList Manual in-line stabilisation is usually used during tracheal intubation of trauma patients to minimise movement of the cervical spine and prevent any further neurological injury. Use of a bougie in combination with laryngoscopy may reduce the forces exerted on the cervical spine. To evaluate the difference in force applied to the head and neck during tracheal intubation with a Macintosh laryngoscope with or without simultaneous use of a bougie. Randomised, crossover simulation study. Simulation laboratory, Anaesthetic Department, Queen's Hospital, Romford between March and April 2012. Twenty anaesthetists, all with a minimum of 1 year of anaesthetic experience. Participants used either a Macintosh laryngoscope alone, or in combination with a bougie in a Laerdal SimMan manikin with a simulated difficult airway and manual in-line stabilisation. The force exerted during laryngoscopy. Success rate and time taken to tracheal intubation were also measured. Significantly less force was exerted utilising a Macintosh laryngoscope in combination with a bougie compared with the laryngoscope alone (24.9 versus 44.5 N; P < 0.001). The trachea was successfully intubated on all occasions within 120 s. The use of a bougie was associated with a nonsignificant reduction in the time to tracheal intubation. To minimise the force of laryngoscopy and movement of a potentially unstable cervical spine injury, consideration should be given to the early use of a bougie.
Author Sherren, Peter B
Wijayatilake, Dhuleep S
Hung, Rachel K Y
Lewinsohn, Asher
Jovaisa, Tomas
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Snippet Manual in-line stabilisation is usually used during tracheal intubation of trauma patients to minimise movement of the cervical spine and prevent any further...
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StartPage 563
SubjectTerms Cross-Over Studies
Humans
Intubation, Intratracheal - methods
Laryngoscopy
Manikins
Title Does the use of a bougie reduce the force of laryngoscopy in a difficult airway with manual in-line stabilisation?: a randomised crossover simulation study
URI https://www.ncbi.nlm.nih.gov/pubmed/23839073
Volume 30
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