Training for neonatal resuscitation with the laryngeal mask airway: a comparison of the LMA-ProSeal and the LMA-Classic in an airway management manikin
Training for neonatal resuscitation with the laryngeal mask airway: a comparison of the LMA-ProSeal and the LMA-Classic in an airway management manikin
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DOI：
10.1111/j.1460-9592.2006.01921.x
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发表时间：
2006-10-01
影响因子：
1.7
通讯作者：
Trevisanuto, Daniele
中科院分区：
文献类型：
--
作者：
Micaglio, Massimo;Doglioni, Nicoletta;Trevisanuto, Daniele
背景：新生儿复苏是参与产科套房的医疗保健专业人员的必备技能。由于伦理原因，不可能在新生儿身上传授和练习呼吸道管理技能，而假人则用于此目的。经典喉罩呼吸机(CLMA)在新生儿复苏过程中是一种有效的呼吸道管理装置。最近生产了新生儿尺寸的LMA-ProSeal(TM)(PLMA)，但没有关于其性能的比较数据。我们描述了不同医护人员在专用呼吸道管理假人中使用新生儿cLMA和新生儿PLMA时的性能比较。方法：对35名医护人员进行简要描述，然后在监督下在单个模特上插入15分钟。然后，每个受训者被指示插入两个设备四次。由单人非盲法观察者记录人工肺从置入到第一次充气的时间(插入时间，IT)。首次尝试成功率PLMA高于cLMA(97.1%vs92.1%；P<；0.01)。平均+/-SD(范围)IT明显低于PLMA[10.47+/-2.85(6-22)S vs11.34+/-2.5(7-18)S；P<；0.01]。CLMA的平均+/-SD(范围)IT为12.31+/-3.54(7-22)S和9.2+/-2.34(6-16)S(P<；0.01)。平均+/-SD(范围)IT为12.71+/-2.52(8-18)S和10.17+/-2.28(7-14)S(P<；0.01)。两组间差异无统计学意义。结论：两种LMA均易于由不同产房工作人员放置。PLMA(使用介入者工具)比cLMA具有更高的首次尝试成功率。医生、护士、助产士之间的表现没有差异，同样建立了人体通气机。一次简短的假人训练可以显著减少IT。PLMA组与cLMA组的IT时间较长无临床相关性。
Background : Neonatal resuscitation is a mandatory skill for healthcare professionals involved in maternity suites. For ethical reasons, it is impossible to teach and practice airway management skills on neonates, and manikins are used for this purpose. The Classic Laryngeal Mask Airway TM (cLMA) is accepted as an effective device for airway management during neonatal resuscitation. A neonatal size of the LMA-ProSeal(TM) (PLMA) was recently produced, but there are no comparative data on its performance. We describe the comparison of the performances of the neonatal cLMA and the neonatal PLMA when used by different healthcare professionals in a dedicated airway management manikin.Methods: Thirty-five healthcare professionals, were given a brief description of the two devices followed by 15 min of supervised insertions on a single manikin. Every trainee was then instructed to insert both devices four times. The time from insertion to the first inflation of the artificial lungs (insertion time, IT) was recorded by a single unblinded observer.Results: No failed insertions were recorded. The success rates of the first attempt were higher with the PLMA than the cLMA (97.1% vs 92.1%; P < 0.01). The mean +/- SD (range) IT was significantly lower with the cLMA compared with the PLMA [10.47 +/- 2.85 (6-22) s vs 11.34 +/- 2.5 (7-18) s; P < 0.01]. The mean +/- SD (range) IT of the cLMA was 12.31 +/- 3.54 (7-22) s for the first positioning and 9.2 +/- 2.34 (6-16) s for the fourth (P < 0.01). The mean +/- SD (range) IT of the PLMA was 12.71 +/- 2.52 (8-18) s for the first positioning and 10.17 +/- 2.28 (7-14) s for the fourth (P < 0.01). There were no significant differences among groups.Conclusions: Both LMAs are easy to insert by different delivery-room workers. PLMA (with the introducer tool) has a higher success rate at first attempt than cLMA. Manikin ventilation was established equally without difference in performance among doctors, nurses, midwives. A brief manikin-training reduces the IT significantly. The longer IT of PLMA vs cLMA is without clinical relevance.