Effect of cardiopulmonary resuscitation on intubation using a Macintosh laryngoscope, the AirWay Scope, and the gum elastic bougie: A manikin study

From Resuscitation:

Physicians could encounter difficult intubation during cardiopulmonary resuscitation (CPR) in trauma patients due to the patient’s movement from continuous chest compression and to cervical stabilisation. Therefore, first, we evaluated the impact of chest compression with or without cervical stabilisation on intubation with a Macintosh laryngoscope. Next, we compared difficulty in intubation among the Macintosh laryngoscope, AirWay Scope (AWS), and gum elastic bougie (GEB) with the Macintosh laryngoscope in three simulated CPR scenarios in a randomised, controlled, cross-over study design.

Results

Continuous chest compression increased difficulty in intubation with the Macintosh laryngoscope, compared with the control scenario. Concurrent application of cervical stabilisation further increased the difficulty, compared with application of chest compression alone. Of the three devices compared, the AWS facilitated the easiest intubation, and the GEB facilitated the second-easiest intubation in all scenarios, though the intubation time was slightly longer with the GEB than with other devices.

Conclusion

CPR employing continuous chest compression with or without cervical stabilisation caused difficult intubation with the Macintosh laryngoscope. The AWS and GEB facilitated the easiest and second-easiest intubation, respectively, even during CPR employing continuous chest compression with or without cervical stabilisation in a manikin.

Deserted ED

From the Boston Herald:

A Brockton hospital is investigating after an Abington family said they had to leave the emergency room with a sick infant because they couldn’t find any medical personnel to help them.

Margo LaPointe tells The Enterprise newspaper that she went to Signature Healthcare Brockton Hospital’s emergency room just after midnight Tuesday because her 11-month-old son was having difficulty breathing.

She banged on doors, but no one responded. A security guard finally told her the medical staff was busy and unable to see her son. She and her husband drove eight miles to South Shore Hospital in Weymouth where the boy was treated for pneumonia.