RESUMO
The LMA Supreme has been suggested for use in emergency situations by medical personnel with no experience in endotracheal intubation. We evaluated the LMA Supreme when inserted by non-anaesthetists, firstly in a manikin and then in patients. Fifty airway novices inserted a LMA Supreme in a manikin without any complications so we proceeded to the patient phase. Fifty airway novices inserted the LMA Supreme in anaesthetised patients undergoing elective surgery. First time insertion success rate was 86% and overall insertion success rate was 100%. Mechanical ventilation was successful in all cases. Median (IQR [range]) time to establish an airway was 34 s (26-40 [18-145] s). Median (IQR [range]) pharyngeal seal pressure was 23 cmH(2)O (19-28 [13-40] cmH(2)O). There were no important complications. Results are consistent with previous studies of use of the LMA Supreme by airway experts. We conclude that the LMA supreme is suitable for use by airway novices. Further research is needed before it may be recommended for cardiopulmonary resuscitation and emergency airway use.
Assuntos
Competência Clínica , Máscaras Laríngeas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anestesia Geral , Desenho de Equipamento , Feminino , Humanos , Intubação Intratraqueal/instrumentação , Intubação Intratraqueal/normas , Masculino , Manequins , Pessoa de Meia-Idade , Adulto JovemRESUMO
Image capture systems that display and record endoscopic images are important for documentation and teaching. We have modified a universal serial bus microscope to couple with most clinical endoscopes used in our practice. This very economical device produces images suitable for teaching, and potentially for clinical use. The implications of this could be significant for teaching, patient education, documentation and the developing world.
Assuntos
Endoscópios , Otolaringologia/instrumentação , Fotografação/instrumentação , Gravação em Vídeo/instrumentação , Humanos , Otolaringologia/educação , Ambulatório Hospitalar , Ensino/métodosRESUMO
The aim of this study is to compare the brightness of laryngoscope light between instruments, and the variability within the same instrument. A secondary aim is to compare the light from a reusable laryngoscope with a single use design. Testing equipment was constructed which provided a qualitative measure of light output from laryngoscopes. Anaesthetists assessed the minimum acceptable brightness for intubation using the intubating mannikin and a variable brightness laryngoscope. Laryngoscopes in anaesthetic rooms around the hospital were then tested repeatedly, and the results were compared to the anaesthetists' opinions. There was considerable intersubject and intrasubject variation in the reusable design, often failing to satisfy the minimum brightness. The single use blades were found to be brighter and more reliable than reusable blades.
