Pre-hospital i-gel blind intubation for trauma: a simulation study

OBJECTIVE: This study aimed to evaluate the efficacy of i-gel blind intubation (IGI) as a rescue device for definitive airway management in ground intubation for pre-hospital trauma patients. METHODS: A prospective randomized crossover study was conducted with 18 paramedics to examine intubation performance of two blind intubation techniques through a supraglottic airway devices (IGI and laryngeal mask airway Fastrach), compared with use of a Macintosh laryngoscope (MCL). Each intubation was conducted at two levels of patient positions (ground- and stretcher-level). Primary outcomes were the intubation time and the success rate for intubation. RESULTS: The intubation time (sec) of each intubation technique was not significantly different between the two positions. In both patient positions, the intubation time of IGI was shortest among the three intubation techniques (17.9±5.2 at the ground-level and 16.9±3.8 at the stretcher-level). In the analysis of cumulative success rate and intubation time, IGI was the fastest to reach 100% success among the three intubation techniques regardless of patient position (all P < 0.017). The success of intubation was only affected by the intubation technique, and IGI achieved more success than MCL (odds ratio, 3.6; 95% confidence interval, 1.1 to 11.6; P=0.03). CONCLUSION: The patient position did not affect intubation performance. Additionally, the intubation time with blind intubation through supraglottic airway devices, especially with IGI, was significantly shorter than that with MCL.

Rehabilitation of Transplantee and Transplant Games / 대한이식학회지

Many transplant recipients believe that exercise or physical activity after transplantation will have adverse effects on the body and the grafted organ, and even more, some of them believe that the grafted organ will tear off from the vascular bed inside of the abdominal cavity. As a result, many recipients are isolated from social life even after successful recovery of the grafted organ function. However, rehabilitation by physical exercise and activity is essential to return to normal social life. In 1978, a transplantee's sport game known as the Transplant Olympics, which later changed to the World Transplant Games, was started to improve the quality of life and develop friendships between transplant recipients globally. This event promotes improvement of recipient's life quality while delivering an important message to the public. This is because by engaging in sports activities, transplantees can show their healthy life after transplantation to the public. This can also improve self-esteem of the family of organ donors and allow them to verify that their decision to donate was not in vain. Additionally, the public can realize the benefits of transplantation and necessity for organ donation. Finally, the early return to social life and normal family life after transplantation will also reduce the national budget for health insurance. Although sports clubs are located in all transplant centers in Korea, no continuous athletic meetings or transplant sport organization exist nationwide. This problem is exacerbated by the lack of concern that transplant physicians and surgeons show toward recipients' physical activity and exercise. Therefore, in this study, we reviewed the significance of physical activity after transplantation and describe the world transplant games and domestic games to enable development of a recipient rehabilitation plan.

The Characteristics of Firefighter Burn Injuries in a Burn Center: A Retrospective Epidemiological Study

PURPOSE: Firefighters are vulnerable to burn injury during firefighting. In extensive fires, conducted heat and radiant heat can cause burn injury even though firefighters are not directly exposed to fire. There has been increasing interest in the health problems of firefighters considerably since Hongje-dong fire of 2001, which claimed the lives of six fireman. However, there have been no studies done on the characteristics of firefighter burn injuries in South Korea. Therefore, we investigated the characteristics of firefighter burn injuries in a burn center. METHODS: A retrospective, single-center research was performed between Jan 2006 to Dec 2015. 24 firefighters came to the burn center. The electronic medical records of patients were reviewed. RESULTS: Flame burns (87.5%) were the major cause of burn in firefighter. All the patients suffered second-degree or third-degree burns. Mean burn size was 6.1±6.7%. 22 of 24 patients were hospitalized and 2 of 22 hospitalized patients admitted to intensive care unit. Mean length of hospitalization was 29.1±23.7 days and mean length of intensive care unit hospitalization was 6.0±1.4 days. The face was the site most commonly burned, representing 25.8% of injuries. The hand/wrist, upper extremity, and neck were the next largest groups, with 19.4, 12.9, 11.3% of the injuries, respectively. CONCLUSION: Firefighter burn injuries occur to predictable anatomic sites with common injury patterns. The burn size was small but, admitted patients need about 30 days of hospitalization.

Comparison of blind intubation through supraglottic devices and direct laryngoscopy by novices: a simulation manikin study

OBJECTIVE: This study aimed to compare intubation performance between blind intubation through supraglottic airway devices and direct laryngoscopy by novices under manikin simulation. We hypothesized that the intubation time by novices using supraglottic airway devices was superior to that with the Macintosh laryngoscope (MCL). METHODS: A prospective, randomized crossover study was conducted with 95 participants, to evaluate i-gel, air-Q, LMA Fastrach, and MCL devices. Primary outcomes were the intubation time and the success rate for intubation. RESULTS: The i-gel showed the shortest insertion and tube passing time among the four devices; the i-gel and air-Q also showed the shortest total intubation time (all P<0.0083; i-gel vs. air-Q, P=0.03). The i-gel and MCL showed the highest cumulative success rate (all P<0.0083; i-gel vs. MCL, P=0.12). CONCLUSION: Blind intubation through the i-gel showed almost equal intubation performance compared to direct laryngoscopy.