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Does a 4 diagram manual enable laypersons to operate the Laryngeal Mask Supreme®? A pilot study in the manikin.

Schälte G, Stoppe C, Rossaint R, Gilles L, Heuser M, Rex S, Coburn M, Zoremba N, Rieg A - Scand J Trauma Resusc Emerg Med (2012)

Bottom Line: A significant reduction in the "no-flow-time", quantitatively better chest compressions and an improved quality of ventilation can be demonstrated during CPR using supraglottic airway devices (SADs).No significant difference related to previous BLS training (P = 0.85), technical education (P = 0.07) or gender could be demonstrated (P = 0.25).Improvements in labeling and the quality of instructional photographs may reduce individual error and may optimize understanding.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Anesthesiology, University Hospital Aachen, Aachen, Germany. gschaelte@ukaachen.de

ABSTRACT

Background: Bystander resuscitation plays an important role in lifesaving cardiopulmonary resuscitation (CPR). A significant reduction in the "no-flow-time", quantitatively better chest compressions and an improved quality of ventilation can be demonstrated during CPR using supraglottic airway devices (SADs). Previous studies have demonstrated the ability of inexperienced persons to operate SADs after brief instruction. The aim of this pilot study was to determine whether an instruction manual consisting of four diagrams enables laypersons to operate a Laryngeal Mask Supreme® (LMAS) in the manikin.

Methods: An instruction manual of four illustrations with speech bubbles displaying the correct use of the LMAS was designed. Laypersons were handed a bag containing a LMAS, a bag mask valve device (BMV), a syringe prefilled with air and the instruction sheet, and were asked to perform and ventilate the manikin as displayed. Time to ventilation was recorded and degree of success evaluated.

Results: A total of 150 laypersons took part. Overall 145 participants (96.7%) inserted the LMAS in the manikin in the right direction. The device was inserted inverted or twisted in 13 (8.7%) attempts. Eight (5.3%) individuals recognized this and corrected the position. Within the first 2 minutes 119 (79.3%) applicants were able to insert the LMAS and provide tidal volumes greater than 150 ml (estimated dead space). Time to insertion and first ventilation was 83.2 ± 29 s. No significant difference related to previous BLS training (P = 0.85), technical education (P = 0.07) or gender could be demonstrated (P = 0.25).

Conclusion: In manikin laypersons could insert LMAS in the correct direction after onsite instruction by a simple manual with a high success rate. This indicates some basic procedural understanding and intellectual transfer in principle. Operating errors (n = 91) were frequently not recognized and corrected (n = 77). Improvements in labeling and the quality of instructional photographs may reduce individual error and may optimize understanding.

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Related in: MedlinePlus

Laryngeal mask Supreme® and indicator labels. BMV ISO connector and estimated depth of insertion (mouth) were labeled red.
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Figure 1: Laryngeal mask Supreme® and indicator labels. BMV ISO connector and estimated depth of insertion (mouth) were labeled red.

Mentions: A technical step-by-step instruction manual for the suggested use of the LMAS, inflation syringe and BMV had been prepared. Pictures illustrating the key actions and the suggested correct use of the devices were prepared and displayed on an instruction sheet (Figure 1). For simplicity and to aid recognition the LMAS and the BMV connectors were labeled red. A further mark was added to the laryngeal mask labeling roughly the correct depth of insertion (Figure 2). The cuff inflation syringe was prepared with a fixed volume of 20 ml air. All devices were packaged in a bag together with the instruction sheet. Squeezing the BMV was displayed using two hands. The LMAS (size 4) was established to fit to the manikin's anatomy and to provide an adequate seal after the cuff has been inflated with 20 ml air.


Does a 4 diagram manual enable laypersons to operate the Laryngeal Mask Supreme®? A pilot study in the manikin.

Schälte G, Stoppe C, Rossaint R, Gilles L, Heuser M, Rex S, Coburn M, Zoremba N, Rieg A - Scand J Trauma Resusc Emerg Med (2012)

Laryngeal mask Supreme® and indicator labels. BMV ISO connector and estimated depth of insertion (mouth) were labeled red.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3375204&req=5

Figure 1: Laryngeal mask Supreme® and indicator labels. BMV ISO connector and estimated depth of insertion (mouth) were labeled red.
Mentions: A technical step-by-step instruction manual for the suggested use of the LMAS, inflation syringe and BMV had been prepared. Pictures illustrating the key actions and the suggested correct use of the devices were prepared and displayed on an instruction sheet (Figure 1). For simplicity and to aid recognition the LMAS and the BMV connectors were labeled red. A further mark was added to the laryngeal mask labeling roughly the correct depth of insertion (Figure 2). The cuff inflation syringe was prepared with a fixed volume of 20 ml air. All devices were packaged in a bag together with the instruction sheet. Squeezing the BMV was displayed using two hands. The LMAS (size 4) was established to fit to the manikin's anatomy and to provide an adequate seal after the cuff has been inflated with 20 ml air.

Bottom Line: A significant reduction in the "no-flow-time", quantitatively better chest compressions and an improved quality of ventilation can be demonstrated during CPR using supraglottic airway devices (SADs).No significant difference related to previous BLS training (P = 0.85), technical education (P = 0.07) or gender could be demonstrated (P = 0.25).Improvements in labeling and the quality of instructional photographs may reduce individual error and may optimize understanding.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Anesthesiology, University Hospital Aachen, Aachen, Germany. gschaelte@ukaachen.de

ABSTRACT

Background: Bystander resuscitation plays an important role in lifesaving cardiopulmonary resuscitation (CPR). A significant reduction in the "no-flow-time", quantitatively better chest compressions and an improved quality of ventilation can be demonstrated during CPR using supraglottic airway devices (SADs). Previous studies have demonstrated the ability of inexperienced persons to operate SADs after brief instruction. The aim of this pilot study was to determine whether an instruction manual consisting of four diagrams enables laypersons to operate a Laryngeal Mask Supreme® (LMAS) in the manikin.

Methods: An instruction manual of four illustrations with speech bubbles displaying the correct use of the LMAS was designed. Laypersons were handed a bag containing a LMAS, a bag mask valve device (BMV), a syringe prefilled with air and the instruction sheet, and were asked to perform and ventilate the manikin as displayed. Time to ventilation was recorded and degree of success evaluated.

Results: A total of 150 laypersons took part. Overall 145 participants (96.7%) inserted the LMAS in the manikin in the right direction. The device was inserted inverted or twisted in 13 (8.7%) attempts. Eight (5.3%) individuals recognized this and corrected the position. Within the first 2 minutes 119 (79.3%) applicants were able to insert the LMAS and provide tidal volumes greater than 150 ml (estimated dead space). Time to insertion and first ventilation was 83.2 ± 29 s. No significant difference related to previous BLS training (P = 0.85), technical education (P = 0.07) or gender could be demonstrated (P = 0.25).

Conclusion: In manikin laypersons could insert LMAS in the correct direction after onsite instruction by a simple manual with a high success rate. This indicates some basic procedural understanding and intellectual transfer in principle. Operating errors (n = 91) were frequently not recognized and corrected (n = 77). Improvements in labeling and the quality of instructional photographs may reduce individual error and may optimize understanding.

Show MeSH
Related in: MedlinePlus