Abstracts 1x7

BLIND ORAL INTIJBATION VIA THE LARYNGEAL MASK AIRWAY: A VIABLE EMERGENCY ALTERNATIVE

Or DC Bryden FRCA, Royal Preetvn Hospital, Preston. UK Dr CL Gwinnutt FRCA Hwe Hospital, Salfard, UK.

&&guw&L Endofrecheel lmubetion is the most effectwe method of securing the airway end enewing effective ventiletmn dwmg cerdlo(xl(monsry reeuecitetion ICPR). However, it is 8 skit which takes hme to Ieem end retemion is poor’. The Leryngeel Mask Avwav lLMAI has been pfopaed as an alternative metkmd of eirwev manegemem. but while allowing ventilation, it does not guaremee protection egeinst aspiretionz. w TO ilsess th-e feaeibilqy of teaching norrmedicel staff the technique of bknd oral tracheel inwX@tiOn vie fhe LMA. To cwnpere thle techmque wth their ability to perform convemiomf keyngowop+c imubetin. f&I&& Fdlow*g Ethi& Cuemittee ep+mvel, eQht nwees with no previous intubetion ex~a, unn mrda*y leaghl e&l-m anvsmianal tmkl imthtion or LMA guided intubation on e mennequh. Once they were rslfebfy able to ac#eve the skill in 30 seconds, tlwy then fzttempted to irrmbete consenting, ewesthetieed adults. After mrubetmg e maximum of 10 ps(ams. eech wee wee then taught the eltemetwe techniaue end the Dmeess r(Lwned. f3sa& Makm t& time.for eech techmque wee 30 minutes. 140 patients were @mubated. 70 bv each technique. The LMA we6 successfulk inserted in 67i70 (96%) pWent.s withi, 30 arconds. lmubetim within 30 wax& w& achiaved in 42/70@0%1 patents via a LMA cMnpe& to 27/70(39%) using Isryngoecopy. Using each etudem a6 their own cantrol, date mtelyeis ueiw a 2 eempfe ‘t’ tea showed no signiflcem difference betwssn d-a two ~~&I@JM Ip-0.11,95% confidence imewel: -0.09-0.53). AneWe for the inffueme of eech technique on the other lthe ‘period effect’) wee not sMfii fp=O.291. Review of the mtis et 24 hours reveeled no eirwv woblems. Cnt&g& Cwk!g CR, eirwey control and effectwe ventilation should be achieved es repdly es possible. The LMA has been shown to facilitate ventilation and the present study demonetretee thet subsequent mtubatum using the LMA es e conduit is es successful es conventwel leryngoecoplc imubetion. We bekeve that this technique may heve advantages m terms of skill retention for inexpenenced personnel over the visuc- spataa’ metbod of dtrect laryngoscopy and tntubatlon.

1 Moms F et al. Cerdwpulmanery rewwtation skills of prereglstretlon house othcers hve veers on Brlt Med J ,991: 302, 626~7 2 ilone BJ et al The use of the Laryngeal Mask Away by nurses dur,“g ,:ardw,o\~lmonarv res,,sc,tet,o”. Ansesthesia ,994, 49. 3 7

&NEW IND~Il SUCCESSFUL RE&JSCITATION: 24- HOUR STABLE SURvnrAL

&&&Q&&@: Director, Medical Division, Magen David Adorn in Israel, Tel Aviv, Israel

INTUBA’I’ION DETECMON DEVICES LN F’RKEOS~AL CARE

Lockey D and Woodward W Department of Anaestb&a, Frenchay Hospital, Bristol, UK

anddimtvi!&ofl. &dtr:TlRWCCdevigUplWg@yddilWViSh~ idaUi6cdtbepos&ionaf8ll1oOtubea.The idaHalsnso~~but tracbd ilsubdm as txmpbgd. It also positionofoneotbertube. Dbcmhnz Thax was no pfblmaeoftbetwod&ces. uMuitlbleintbe~~anriroamcatforth6 l ItofFasw&satqpsovertltenmd&c&Weedcviotwtiicbis

simpk.,disblemldtulchlelm~. l Itdepmdaonapowersourceandisimxanteifnotc&@ured

corRdybefweuse. *Itcanaotberdieduponiftbereisanyresidu8lspoat8neous

bradingwhicItmayweUbetbecasewhefemuscierelfaantsare not used to intubate.

PURPOSE This study attempted to Eunice an additional criterion for

sudl m6usc&ion: 2Chouf survival after rsuacitation, including defmitiin of patient stntus (stabklunstable). The two common d&i&ions of SME&II rdawcitation: ROSC and discharge from hospital do not co&itute good fixdback for resuscitation teams.

-AM).RdlirrxoDs 1000 cara of -tation following cardiac area rqorted by

MDA teams accord& to the Utstein templatm were examined. Patients’ status 24 hours a&r resw&ntion - stable (brading spcntanwudy mdlor conscious) or unstable - was determined

Of loo0 cases checked, 439 showed ROSC in the mcy Ward. 2S2 were a&e 24 hours later, 50% of them stable. Oftbe 219 followed-up, 118 died in hoqital; 101 (46%) were discharged. Of those defined as stable, 60?? were discharged

Lkithiq 5ucw8sfid resuscitation as 24-hour Stable survival is better than the two Utatda methods for resuscitation analysis.

This criterion is ftdable witbin only 24 boun; it prim&y mflectstbeeEortsoftbeprebospitalteamrmdbettcrarpressestbe patient’s chance of kaviag hospital alive. (Discbmge rates: 23% according to ROSC; 60% according to 24-hour stability.)

ORAL PRESENTATIONS