Success Rate on Endotracheal Intubation with Prone versus Kneeling Position in Mannequin Model with Limitation of Neck Movement: A Cross Over Study
1
Issued Date
2022-01-01
Resource Type
eISSN
11791500
Scopus ID
2-s2.0-85129340247
Journal Title
Open Access Emergency Medicine
Volume
14
Start Page
177
End Page
182
Rights Holder(s)
SCOPUS
Bibliographic Citation
Open Access Emergency Medicine Vol.14 (2022) , 177-182
Suggested Citation
Tangkulpanich P., Jenpanitpong C., Patchkrua J., Silarak C., Srinaowech N., Thiamdao N., Yuksen C. Success Rate on Endotracheal Intubation with Prone versus Kneeling Position in Mannequin Model with Limitation of Neck Movement: A Cross Over Study. Open Access Emergency Medicine Vol.14 (2022) , 177-182. 182. doi:10.2147/OAEM.S360169 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/86573
Title
Success Rate on Endotracheal Intubation with Prone versus Kneeling Position in Mannequin Model with Limitation of Neck Movement: A Cross Over Study
Author's Affiliation
Other Contributor(s)
Abstract
Purpose: Endotracheal intubation is a lifesaving procedure for airway management but is more complex when performed in patients lying on the ground and requiring cervical spine immobilization. This study aims to compare the optimal technique between prone and kneeling positions in increasing intubation success rate on these prehospital trauma patients. Patients and Methods: This study was an experimental study on a mannequin. Paramedic students performed intubation on the supine mannequin, which was applied with a rigid cervical collar and manual in-line stabilization. The participants were randomly assigned to intubate in a prone or kneeling position as the first method, then perform another method seven days later. Study outcomes include the percentage of successful intubation, time to perform intubation successfully, and Cormack and Lehane’s classification of laryngeal view. Results: Thirty-nine participants were enrolled in this study; 22 were male (56.41%). The mean age, weight, and height were 23.15 ± 4.75 years, 67.38 ± 17.39 kg, and 167.36 ± 8.70 cm., respectively. The percentage of successful intubation in prone (37 [94.90%]) was higher than kneeling position (35 [89.74%]), but there was no statistically significant (p-value = 0.675). Time to intubation successfully, the number of attempts, and Cormack & Lehane's laryngeal view classification were not significantly different between prone and kneeling groups (p-value = 0.808, 0.814, and 0.948, respectively). Conclusion: Intubation with the prone or kneeling position on a mannequin, lying on the ground with cervical spine immobilization, has no statistical difference. Both intubation approaches appear to be effective in successful and rapid intubation, proper glottic visualization and low attempts.