+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Comparing no-flow time during endotracheal intubation versus placement of a laryngeal mask airway during a simulated cardiac arrest scenario



Comparing no-flow time during endotracheal intubation versus placement of a laryngeal mask airway during a simulated cardiac arrest scenario



Simulation in Healthcare 9(3): 156-160



Traditionally, pausing chest compressions during airway management in a cardiac arrest has been the accepted norm. However, updated American Heart Association and the European Resuscitation Council guidelines for Advanced Cardiac Life Support emphasize reducing pauses in chest compressions, often referred to as "no-flow time," to improve return of spontaneous circulation. We used simulation to evaluate whether placing a laryngeal mask airway versus endotracheal intubation via direct laryngoscopy would reduce no-flow times during a simulated cardiac arrest. A crossover trial of 41 respiratory therapists (RTs) performed airway management in a simulated cardiac arrest. The RTs were told that bag mask ventilation was inadequate, and either an endotracheal tube or laryngeal mask airway was needed. They were informed to request the cessation of chest compressions only if needed to complete the airway maneuver. The study was terminated when ventilation was achieved. The scenario was repeated with the same RT placing the alternative airway. Insertion time and no-flow times were recorded. Neither endotracheal intubation via direct laryngoscopy nor laryngeal mask airway placement increased no-flow time. Only 1 participant requested cessation of chest compressions during direct laryngoscopy for 2.3 seconds (P = 0.175). However, ventilation was established significantly faster with a laryngeal mask airway compared with endotracheal intubation (49.2 vs. 31.6 seconds, respectively, P < 0.001). We conclude that although neither device was superior to the other with respect to the primary outcome of reducing no-flow time, effective ventilation was established more rapidly with the laryngeal mask airway in the hands of the RTs who participated in this study. These results may be affected by the differences between simulated and human airways.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 052221592

Download citation: RISBibTeXText

PMID: 24310162

DOI: 10.1097/sih.0000000000000002


Related references

Towards evidence based emergency medicine: Best BETs from the Manchester Royal Infirmary. Bet 3. Laryngeal mask airway versus endotracheal intubation or bag-mask ventilation for cardiac arrest in adults. Emergency Medicine Journal 27(6): 477-479, 2010

Meta-analysis of the effects between endotracheal intubation and laryngeal mask airway for patients with out-of-hospital cardiac arrest. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 30(2): 128-133, 2018

Comparison of the laryngeal mask airway versus blind endotracheal intubation in the simulated entrapped patient: a preliminary study. Air Medical Journal 20(2): 21-22, 2001

Randomized trial of endotracheal tube versus laryngeal mask airway in simulated prehospital pediatric arrest. Pediatrics 122(2): E294-E297, 2008

Paramedic King Laryngeal Tube airway insertion versus endotracheal intubation in simulated pediatric respiratory arrest. Prehospital Emergency Care 16(2): 284-288, 2012

Endotracheal intubation versus supraglottic airway placement in out-of-hospital cardiac arrest: A meta-analysis. Resuscitation 93: 20-26, 2015

Comparison of effectiveness of intubation by way of "Gum Elastic Bougie" and "Intubating Laryngeal Mask Airway" in endotracheal intubation of patients with simulated cervical trauma. Revista Brasileira de Anestesiologia 67(3): 238-245, 2017

Laryngeal mask airway versus bag-mask ventilation or endotracheal intubation for neonatal resuscitation. Cochrane Database of Systematic Reviews 3: Cd003314, 2018

Laryngeal mask airway versus bag-mask ventilation or endotracheal intubation for neonatal resuscitation. Cochrane Database of Systematic Reviews 2005(2): Cd003314, 2005

Effect of endotracheal intubation and supraglottic airway device placement during cardiopulmonary resuscitation on carotid blood flow over resuscitation time: An experimental porcine cardiac arrest study. Resuscitation 139: 269-274, 2019

Airway equipment and its maintenance for a non difficult adult airway management (endotracheal intubation and its alternative: face mask, laryngeal mask airway, laryngeal tube). Annales Francaises d'Anesthesie et de Reanimation 22(Suppl. 1): 28s-40s, 2003

Does tracheal intubation really matter? Discrepant survival between laryngeal mask and endotracheal intubation during out-of-hospital cardiac arrest. Journal of the Formosan Medical Association 116(2): 134-135, 2017

Endotracheal intubation in patients with difficult airway: using laryngeal mask airway with bougie versus video laryngoscopy. Medical Gas Research 7(3): 150-155, 2017

Endotracheal intubation versus laryngeal mask airway for esophagogastroduodenoscopy in children. Journal of Pediatric Gastroenterology and Nutrition 59(1): 54-56, 2014

Can the laryngeal mask airway replace endotracheal intubation for airway control? The argument for the laryngeal mask airway. Israel Medical Association Journal 6(4): 240, 2004