Success Rate of Endotracheal Intubation Using Inline Stabilization with and without Cervical Hard Collar; a Comparative Study manual stabilization with or without cervical collar
Archives of Academic Emergency Medicine,
Vol. 8 No. 1 (2020),
7 January 2020
Introduction: Application of a rigid cervical collar may interfere with the laryngeal view, and potentially lead to failed endotracheal intubation (ETI). This study aimed to compare intubation success rates while performing inline stabilization with and without cervical hard collar.
Methods: This randomized prospective comparative study included paramedics working in the Department of Emergency Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand to compare the success rates of endotracheal intubation on manikin using inline stabilization with and without cervical hard collar.
Results: 125 participants were evaluated; 63 in the rigid cervical collar and 62 in the non-cervical hard collar group. The rate of successful intubation was significantly higher using manual stabilization without cervical hard collar (61 (96.8%) vs. 55 (88.7%); p=0.048). The time required to successfully perform intubation was also shorter, with manual stabilization only (14.1 ±20.9 vs. 18.9±29.0; p = 0.081).
Conclusion: It seems that, removal of the rigid cervical collar during ETI in patients with suspected traumatic spine injury could increase the intubation success rate.
- Intubation, Intratracheal; Spinal Injuries; Multiple trauma; Restraint, Physical
How to Cite
Xiong C, Hanafy S, Chan V, Hu ZJ, Sutton M, Escobar M, et al. Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review. BMJ open. 2019;9(11).
Kumar R, Lim J, Mekary RA, Rattani A, Dewan MC, Sharif SY, et al. Traumatic spinal injury: global epidemiology and worldwide volume. World neurosurgery. 2018;113:e345-e63.
Kreinest M, Gliwitzky B, Schüler S, Grützner PA, Münzberg M. Development of a new Emergency Medicine Spinal Immobilization Protocol for trauma patients and a test of applicability by German emergency care providers. Scandinavian journal of trauma, resuscitation and emergency medicine. 2016;24(1):1-10.
Liao S, Popp E, Hüttlin P, Weilbacher F, Münzberg M, Schneider N, et al. Cadaveric study of movement in the unstable upper cervical spine during emergency management: tracheal intubation and cervical spine immobilisation—a study protocol for a prospective randomised crossover trial. BMJ open. 2017;7(8):e015307.
Chan W-H, Cheng C-P, Chiu Y-L, Hsu Y-C, Hu M-H, Huang G-S. Two head positions for orotracheal intubation with the trachway videolight intubating stylet with manual in-line stabilization: A randomized controlled trial. Medicine. 2020;99(17):e19645.
Liao S, Schneider NR, Hüttlin P, Grützner PA, Weilbacher F, Matschke S, et al. Motion and dural sac compression in the upper cervical spine during the application of a cervical collar in case of unstable craniocervical junction—A study in two new cadaveric trauma models. PloS one. 2018;13(4):e0195215.
Yuk M, Yeo W, Lee K, Ko J, Park T. Cervical collar makes difficult airway: a simulation study using the LEMON criteria. Clinical and experimental emergency medicine. 2018;5(1):22.
Oh H, Kim H, Yoon H-K, Lee H-C, Park H-P. No radiographic index predicts difficult intubation using the Optiscope™ in cervical spine surgery patients: a retrospective study. BMC anesthesiology. 2020;20(1):1-10.
Kim JW, Lee KR, Hong DY, Baek KJ, Lee YH, Park SO. Efficacy of various types of laryngoscope (direct, Pentax Airway Scope and GlideScope) for endotracheal intubation in various cervical immobilisation scenarios: a randomised cross-over simulation study. BMJ open. 2016;6(10):e011089.
Kleine-Brüggeney M, Greif R, Schoettker P, Savoldelli GL, Nabecker S, Theiler L. Evaluation of six videolaryngoscopes in 720 patients with a simulated difficult airway: a multicentre randomized controlled trial. BJA: British Journal of Anaesthesia. 2016;116(5):670-9.
Yuksen C, Prachanukool T, Chinsupaluk W, Trainarongsakul T. Videolaryngoscope versus Macintosh Laryngoscope in Stimulated Patients With Limitation of Neck Movements. Ramathibodi Medical Journal. 2014;37(2):71-80.
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