PMID- 33656661
OWN - NLM
STAT- MEDLINE
DCOM- 20230927
LR  - 20230927
IS  - 1863-4362 (Electronic)
IS  - 0021-1265 (Linking)
VI  - 191
IP  - 1
DP  - 2022 Feb
TI  - Evaluation of a novel emergency front of neck access device in a benchtop model 
      of obesity.
PG  - 413-420
LID - 10.1007/s11845-021-02530-5 [doi]
AB  - BACKGROUND: Emergency front of neck access (eFONA) is a critical step in 
      oxygenation in cases of unrelieved airway obstruction. Multiple techniques are 
      used in clinical practice without agreement regarding the optimal approach. We 
      evaluated a novel device, the Cric-Guide (CG), a channelled bougie introducer 
      that enters the airway in a single action and compared it with a 
      scalpel-bougie-tube (SBT) technique in laboratory benchtop model. METHODS: Seven 
      anaesthesiologists attempted eFONA on both obese and non-obese models using both 
      techniques in randomized order on an excised porcine trachea with an intact 
      larynx with variable subcutaneous tissue depth. The primary outcome was 
      successful tracheal cannulation. Secondary outcomes included false passage rate, 
      time and tissue injury. RESULTS: Anaesthesiologists performed 4 
      cricothyroidotomies on each model with each device. The CG was more successful in 
      airway cannulation (47/56 [89.4%] vs. 33/56 [58.9%], P = 0.007). This difference 
      was observed in the obese model only. The CG was associated with fewer false 
      passages than the standard technique in the obese model (8/56 [14.3%] vs. 23/56 
      [41.1%], P = 0.006). There were no significant differences in time to completion 
      or injury patterns between the techniques in the obese model, but the SBT was 
      faster in the non-obese model. There was no difference in the proportion of 
      specimens injured. CONCLUSION: The Cric-Guide device was more successful than the 
      standard SBT technique in airway cannulation in an obese neck model and with 
      equivalent frequency and distribution of injury but performed equivalently in the 
      non-obese model.
CI  - (c) 2021. Royal Academy of Medicine in Ireland.
FAU - Chauhan, Sunil K
AU  - Chauhan SK
AD  - The Rotunda Hospital, Dublin, Ireland.
FAU - Monaghan, Myles
AU  - Monaghan M
AD  - Kilimanjaro Christian Medical Centre, Dodoma, Tanzania.
FAU - McCaul, Conan L
AU  - McCaul CL
AUID- ORCID: 0000-0003-0489-0760
AD  - The Rotunda Hospital, Dublin, Ireland. cmccaul@rotunda.ie.
AD  - The Rotunda Hospital, Mater Misericordiae University Hospital, Dublin, Ireland. 
      cmccaul@rotunda.ie.
LA  - eng
PT  - Journal Article
DEP - 20210303
PL  - Ireland
TA  - Ir J Med Sci
JT  - Irish journal of medical science
JID - 7806864
SB  - IM
MH  - Animals
MH  - Humans
MH  - *Airway Management
MH  - Anesthesiologists
MH  - Clinical Competence
MH  - Cricoid Cartilage/surgery
MH  - Intubation, Intratracheal
MH  - *Neck/surgery
MH  - Obesity
MH  - Swine
OTO - NOTNLM
OT  - Airway
OT  - Cricothyroidotomy
OT  - Emergency
OT  - Front of neck access
OT  - Obesity
EDAT- 2021/03/04 06:00
MHDA- 2022/01/28 06:00
CRDT- 2021/03/03 12:15
PHST- 2020/09/28 00:00 [received]
PHST- 2021/01/26 00:00 [accepted]
PHST- 2021/03/04 06:00 [pubmed]
PHST- 2022/01/28 06:00 [medline]
PHST- 2021/03/03 12:15 [entrez]
AID - 10.1007/s11845-021-02530-5 [pii]
AID - 10.1007/s11845-021-02530-5 [doi]
PST - ppublish
SO  - Ir J Med Sci. 2022 Feb;191(1):413-420. doi: 10.1007/s11845-021-02530-5. Epub 2021 
      Mar 3.