Resuscitation
-
Previous work has shown that insertion of the laryngeal mask airway is a skill that is easily taught to inexperienced operators. In this study we have assessed the ability of non-anaesthetists to maintain an airway in a paralysed, anaesthetised patient in the controlled setting of an anaesthetic room. ⋯ The inspired volume delivered to the patients was standardised using a Penlon Nuffield ventilator attached to the breathing system. Our results showed no difference in success in maintaining the airway between the three techniques or in the mean expired volumes achieved during successful ventilation.
-
It has been suggested that the laryngeal mask has a role to play in the management of the airway during resuscitation both from cardiac arrest and possibly major trauma. Should it be introduced for this purpose, there will be a need to provide training for a very large number of paramedical staff. Currently training in advanced airway management techniques involves live patient practice in theatres; clearly this system is already reaching a limit as paramedics in training often have some difficulty in reaching the prescribed number of procedures. This paper describes experience with a possible alternative utilising only classroom teaching.
-
Clinical Trial Controlled Clinical Trial
The role of laryngeal mask airway in cardiopulmonary resuscitation.
The laryngeal mask airway (LMA) has been newly introduced to anaesthesia practice as an alternative to the endotracheal tube (ETT) or face mask for airway management. It is capable of providing a rapid and easily achieved patent airway that permits positive pressure ventilation within confined limits. In this study, we aim to evaluate the role of the LMA in cardiopulmonary resuscitation (CPR) in 20 patients as an alternative to tracheal intubation. ⋯ In the LMA groups I and III, 12 patients had LMA inserted at the first attempt and three at a second attempt. We concluded that LMA is a good alternative to ETT, although it may not protect against aspiration. We recommend it to be included in CPR chart cards and all medical doctors, nurses and paramedical staff should learn how to use it.
-
We report echocardiographic observations during external chest compression in a patient with marked abnormalities in thoracic anatomy following emergency surgery of aortic arch aneurysm. Transesophageal echocardiography demonstrated direct right ventricular, aortic and left atrial compression, only minimal left ventricular compression and an open mitral valve during closed chest heart massage. Colour flow doppler demonstrated forward blood flow across the mitral valve and along the left ventricular outflow tract during the compression phase. Echocardiographic findings indicate that factors apart from simple cardiac pump mechanism contributed to blood flow during cardiopulmonary resuscitation (CPR) in this postoperative patient after a major thoracic surgical intervention.