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{
    "pk": 17174,
    "title": "Eschmann Introducer Through Laryngeal Mask Airway: A Cadaveric Trial of An Alternate Means of Rescue Intubation",
    "subtitle": null,
    "abstract": "Study Objective: Laryngeal mask airways (LMAs) are often used as airway rescue devices where laryngoscopy is difficult. The LMA does not protect the airway and is preferably replaced with a cuffed endotracheal tube. There are reports of cases where an Eschmann tracheal tube introducer (ETTI) was successfully used to bridge between a standard LMA and an endotracheal tube. This project was designed to determine whether an Eschmann stylet can reliably be passed through an LMA into the trachea as a means of rescue intubation.\n\n\nMethods: Nineteen emergency medicine residents and attending physicians, who were participants in a cadaveric airway course, placed and inflated a size 4 LMA (The Laryngeal Mask Company Ltd., San Diego, CA) on each of six unembalmed human cadavers in the usual fashion. They then attempted to pass a lubricated, 15 Fr, reusable, coude-tipped ETTI (Portex, Smiths Medical, Keene, NH)) through the airspace/handle of the inflated LMA. The LMA was then deflated and removed while the ETTI was held in place. Investigators then determined the location of the ETTI by laryngoscopy.\n\n\nResults: Of 114 attempts at the rescue procedure, 59 resulted in placement of the bougie into the trachea, yielding an overall success rate of 52% (95% CI 48%-56%). There were no significant differences in performance based on level of training of residents or years of experience of attending physicians.\n\n\nConclusions: While not a primary difficult airway option, the use of a ETTI as a bridge device between LMA and endotracheal tube was successful about 50% of the time.  [West J Emerg Med. 2010;11:16-19.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by-nc/4.0"
    },
    "keywords": [
        {
            "word": "Eschmann"
        },
        {
            "word": "intubation"
        },
        {
            "word": "laryngeal mask airway"
        },
        {
            "word": "Emergency Medicine"
        }
    ],
    "section": "Article",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/1x81x4sb",
    "frozenauthors": [
        {
            "first_name": "Joel",
            "middle_name": "A",
            "last_name": "Miller",
            "name_suffix": "",
            "institution": "Carl R. Darnall Army Medical Center, Department of Emergency Medicine, Ft. Hood, TX",
            "department": "None"
        },
        {
            "first_name": "Marc",
            "middle_name": "E",
            "last_name": "Levsky",
            "name_suffix": "",
            "institution": "Seton Medical Center, Division of Emergency Medicine, Daly City, CA",
            "department": "None"
        },
        {
            "first_name": "Melissa",
            "middle_name": "L",
            "last_name": "Givens",
            "name_suffix": "",
            "institution": "Carl R. Darnall Army Medical Center, Department of Emergency Medicine, Ft. Hood, TX",
            "department": "None"
        },
        {
            "first_name": "Michael",
            "middle_name": "A",
            "last_name": "Miller",
            "name_suffix": "",
            "institution": "Tripler Army Medical Center, Department of Emergency Medicine, Honolulu, HI",
            "department": "None"
        }
    ],
    "date_submitted": "2009-01-13T08:00:00Z",
    "date_accepted": "2009-01-13T08:00:00Z",
    "date_published": "2010-04-02T07:00:00Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/17174/galley/8677/download/"
        }
    ]
}