The impact of respiratory protective equipment on difficult airway management: a randomised, crossover, simulation study.

Abstract:

:The current international COVID-19 health crisis underlines the importance of adequate and suitable personal protective equipment for clinical staff during acute airway management. This study compares the impacts of standard air-purifying respirators and powered air-purifying respirators during simulated difficult airway scenarios. Twenty-five anaesthetists carried out four different standardised difficult intubation drills, either unprotected (control), or wearing a standard or a powered respirator. Treatment times and wearer comfort were determined and compared. In the wearer comfort evaluation form, operators rated mobility, noise, heat, vision and speech intelligibility. All anaesthetists accomplished the treatment objectives of all study arms without adverse events. Total mean (SD) intubation times for the four interventions did not show significant differences between the powered and the standard respirator groups, being 16.4 (8.6) vs. 19.2 (5.2) seconds with the Airtraq™; 11.4 (3.4) vs. 10.0 (2.1) seconds with the videolaryngoscope; 39.2 (4.5) vs. 40.1 (4.8) seconds with the fibreoptic bronchoscope scope; and 15.4 (5.7) vs. 15.1 (5.0) seconds for standard tracheal intubation by direct laryngoscopy, respectively. Videolaryngoscopy allowed the shortest intubation times regardless of the respiratory protective device used. Anaesthetists rated heat and vision significantly higher in the powered respirator group; however, noise levels were perceived to be significantly lower than in the standard respirator group. We conclude that standard and powered respirators do not significantly prolong simulated advanced intubation procedures.

journal_name

Anaesthesia

journal_title

Anaesthesia

authors

Schumacher J,Arlidge J,Dudley D,Sicinski M,Ahmad I

doi

10.1111/anae.15102

subject

Has Abstract

pub_date

2020-10-01 00:00:00

pages

1301-1306

issue

10

eissn

0003-2409

issn

1365-2044

journal_volume

75

pub_type

杂志文章,随机对照试验
  • An evaluation of the Universal PAC and Oxford Miniature Vaporizers for paediatric field anaesthesia.

    abstract::A laboratory study has demonstrated that the Universal PAC and Oxford Miniature Vaporizers can be used for paediatric anaesthesia in drawover mode at varying ambient temperatures. Changes in tidal volume have minimal effect on the delivered concentration of halothane from either vaporizer but varying ambient temperatu...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1995.tb06142.x

    authors: Craig GR,Berry CB,Yeats MJ

    更新日期:1995-09-01 00:00:00

  • Postoperative analgesia using papaveretum and orphenadrine. A preliminary trial.

    abstract::The action of orphenadrine when given towards the end of a general anaesthetic is described. It is shown to delay the need for postoperative analgesia and extend the analgesic action of papaveretum. ...

    journal_title:Anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.1979.tb06311.x

    authors: Fry EN

    更新日期:1979-03-01 00:00:00

  • Ventricular fibrillation after accidental injection of bupivacaine into the pericardium.

    abstract::A postoperative cardiac surgical patient developed ventricular fibrillation immediately after accidental pericardial injection of bupivacaine at room temperature. The possible causes, which include systemic toxicity, local vasoconstriction with myocardial ischaemia, local toxic effect of bupivacaine or local hypotherm...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1992.tb04202.x

    authors: Even BJ,De Jongh RF,De Hert SG

    更新日期:1992-12-01 00:00:00

  • Treatment of acute total atelectasis. Use of a double lumen tube.

    abstract::Three cases are described of complete collapse of a lung in the absence of bronchial obstruction. The condition was treated by the application of a sustained high pressure (6 kPa) to the affected lung through one limb of a double lumen bronchial tube whilst intermittent positive pressure ventilation was continued thro...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1985.tb10707.x

    authors: Murray JF

    更新日期:1985-02-01 00:00:00

  • Ethamsylate and blood loss in total hip replacement.

    abstract::Nineteen consecutive patients undergoing total hip replacement under epidural anaesthesia were randomly divided into two groups. The treatment group received 1000 mg of ethamsylate intravenously before induction of anaesthesia. Blood lost during surgery was measured by a colorimetric technique. Closed suction drains w...

    journal_title:Anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.1979.tb06368.x

    authors: Keith I

    更新日期:1979-07-01 00:00:00

  • The TOF-Guard neuromuscular transmission monitor. A comparison with the Myograph 2000.

    abstract::The TOF-Guard neuromuscular monitor uses an accelerometer to measure the response to nerve stimulation. In this study, we have compared it to a standard mechanomyographic monitor, the Myograph 2000, for neuromuscular monitoring in 28 subjects. A train-of-four mode of stimulation was used in both cases. The times taken...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1995.tb06097.x

    authors: Loan PB,Paxton LD,Mirakhur RK,Connolly FM,McCoy EP

    更新日期:1995-08-01 00:00:00

  • Ketamine-diazepam anaesthesia in a patient with carcinoid syndrome.

    abstract::The use of ketamine in patients with carcinoid syndrome is controversial because of the catecholamine response to this agent. Prior administration of diazepam modifies the catecholamine response to ketamine and may make its use in such patients safe. The successful use of a diazepam-ketamine technique for anaesthesia ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1981.tb08862.x

    authors: Eisenkraft JB,Dimich I,Miller R

    更新日期:1981-09-01 00:00:00

  • Effect of orientation of a standard polyvinyl chloride tracheal tube on success rates during awake flexible fibreoptic intubation.

    abstract::We conducted a randomised study in 70 patients to assess the effect of orientation of a standard polyvinyl chloride tracheal tube on the ease of railroading the tube during awake fiberoptic orotracheal intubation. Conventional orientation of the tube (with the bevel of the tube directed to the patient's left) was comp...

    journal_title:Anaesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.2006.04750.x

    authors: Sharma D,Bithal PK,Rath GP,Pandia MP

    更新日期:2006-09-01 00:00:00

  • Training for day-case dental anaesthesia. Oxygen saturation during general anaesthesia administered by dental undergraduates.

    abstract::Sixty-seven patients undergoing general anaesthesia for exodontia as outpatients were studied in order to measure the levels of oxygen saturation. Both the anaesthesia and extractions were performed by fourth year dental undergraduates working under direct supervision. Falls in oxygen saturation in excess of 5% were f...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1984.tb08937.x

    authors: Walsh JF

    更新日期:1984-11-01 00:00:00

  • Evaluation of the Upsherscope. A new rigid fibrescope.

    abstract::A new, rigid intubating fibrescope, the Upsherscope, was evaluated in clinical practice. Intubation was attempted in 200 adult patients and was successful in 191, with a median intubation time of 38 s, range 14-154 s. Intubation was straightforward in just under half of the patients. Difficulties were encountered in p...

    journal_title:Anaesthesia

    pub_type: 临床试验,杂志文章

    doi:10.1111/j.1365-2044.1996.tb12565.x

    authors: Pearce AC,Shaw S,Macklin S

    更新日期:1996-06-01 00:00:00

  • Regional anaesthesia for repeat Caesarean section in a patient with phantom limb pain.

    abstract::The triggering of phantom limb pain by subarachnoid or epidural anaesthesia has been well described leading to the suggestion that neuraxial regional anaesthesia is relatively contraindicated in lower limb amputees. We report our experience of the provision of anaesthesia for repeat Caesarean section on two occasions ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1996.tb07657.x

    authors: Uncles DR,Glynn CJ,Carrie LE

    更新日期:1996-01-01 00:00:00

  • A survey of peri-operative use of magnesium sulphate in adult cardiac surgery in the UK.

    abstract::We conducted a postal survey of cardiac anaesthetists in the UK, to determine the extent of magnesium sulphate (MgSO4) use and the main indications for its administration. Questionnaires were sent to anaesthetists at 35 UK hospitals undertaking adult cardiac surgery. Responses were received from 24 hospitals (69%) tot...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1046/j.1365-2044.2003.03082_1.x

    authors: Roscoe A,Ahmed AB

    更新日期:2003-04-01 00:00:00

  • Tracheal dilatation complicating prolonged tracheal intubation.

    abstract::A patient with severe acute respiratory distress syndrome requiring prolonged tracheal intubation and mechanical ventilation is described. Tracheal dilation was noted to have occurred following an elective surgical tracheostomy. Eventually, the patient was successfully weaned from mechanical ventilation and the trache...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1997.t01-3-010-az010.x

    authors: Rhodes A,Lamb FJ,Grounds RM,Bennett ED

    更新日期:1997-01-01 00:00:00

  • Lumbar epidurography with multi-orifice and single orifice epidural catheters.

    abstract::The spread of iohexol in the epidural space was studied using two types of epidural catheter. Twenty pre-menopausal women undergoing hysterectomy received lumbar epidural analgesia via either multi-orifice or single orifice catheters. Twenty-four hours after surgery, iohexol was injected before catheter removal with t...

    journal_title:Anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.1996.tb07891.x

    authors: Magides AD,Sprigg A,Richmond MN

    更新日期:1996-08-01 00:00:00

  • An international consensus statement on the management of postoperative anaemia after major surgical procedures.

    abstract::Despite numerous guidelines on the management of anaemia in surgical patients, there is no pragmatic guidance for the diagnosis and management of anaemia and iron deficiency in the postoperative period. A number of experienced researchers and clinicians took part in a two-day expert workshop and developed the followin...

    journal_title:Anaesthesia

    pub_type: 共识发展会议,杂志文章,评审

    doi:10.1111/anae.14358

    authors: Muñoz M,Acheson AG,Bisbe E,Butcher A,Gómez-Ramírez S,Khalafallah AA,Kehlet H,Kietaibl S,Liumbruno GM,Meybohm P,Rao Baikady R,Shander A,So-Osman C,Spahn DR,Klein AA

    更新日期:2018-11-01 00:00:00

  • A national survey into the peri-operative anaesthetic management of patients presenting for surgical correction of a fractured neck of femur.

    abstract::We conducted a national postal survey of trauma anaesthetists in the UK to ascertain current practice for the peri-operative anaesthetic management in patients with fractured necks of femur. We received 155 replies from 218 questionnaires sent (71.1% response rate). Regional anaesthesia was preferred by 75.8% of respo...

    journal_title:Anaesthesia

    pub_type: 杂志文章,多中心研究

    doi:10.1111/j.1365-2044.2007.05328.x

    authors: Sandby-Thomas M,Sullivan G,Hall JE

    更新日期:2008-03-01 00:00:00

  • A comparison of low vs conventional-dose heparin for minimal cardiopulmonary bypass in coronary artery bypass grafting surgery.

    abstract::The biocompatibility of minimal extracorporeal circuits has improved; however, anticoagulation is still required. We compared standard high-dose anticoagulation with a low-dose heparin regimen in a retrospective study of patients who underwent coronary bypass surgery using minimal cardiopulmonary bypass. One hundred p...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.2011.06709.x

    authors: Fromes Y,Daghildjian K,Caumartin L,Fischer M,Rouquette I,Deleuze P,Bical OM

    更新日期:2011-06-01 00:00:00

  • A prospective randomised double blind study to evaluate the effect of peribulbar block or topical application of local anaesthesia combined with general anaesthesia on intra-operative and postoperative complications during paediatric strabismus surgery.

    abstract::We studied 45 ASA I/II children aged between 2 and 13 years scheduled for elective strabismus surgery, randomly allocated to receive either a peribulbar block or topical lidocaine 2% combined with general anaesthesia, or general anaesthesia alone. The incidence and severity of the occulocardiac reflex, the requirement...

    journal_title:Anaesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.2007.05220.x

    authors: Gupta N,Kumar R,Kumar S,Sehgal R,Sharma KR

    更新日期:2007-11-01 00:00:00

  • EMLA patch for spinal puncture. A comparison of EMLA patch with lignocaine infiltration and placebo patch.

    abstract::We have prospectively assessed pain and anxiety of spinal puncture in 180 adult patients randomly allocated to one of three equal groups. On the morning of surgery group 1 had an EMLA patch, whereas group 2 and 3 had placebo patches. Group 2 also had infiltration analgesia with 2 ml lignocaine 2% with adrenaline, imme...

    journal_title:Anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1046/j.1365-2044.1998.00608.x

    authors: Koscielniak-Nielsen Z,Hesselbjerg L,Brushøj J,Jensen MB,Pedersen HS

    更新日期:1998-12-01 00:00:00

  • Detection of inner tube defects in co-axial circle and Bain breathing systems: a comparison of occlusion and Pethick tests.

    abstract::The performance of the occlusion and Pethick tests in detecting faulty inner tubes in co-axial circle and Bain systems was compared. Twelve co-axial circle and 12 Bain anaesthetic breathing systems were tested using the occlusion and the Pethick tests. For each system, three tubes were intact, and the remaining nine h...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.2008.05568.x

    authors: Szypula KA,Ip JK,Bogod D,Yentis SM

    更新日期:2008-10-01 00:00:00

  • Cardiovascular effects of epidural local anaesthetics. Comparison of 0.75% bupivacaine and 0.75% ropivacaine, both with adrenaline.

    abstract::The cardiovascular effects of 20 ml 0.75% bupivacaine with adrenaline 5 micrograms/ml injected epidurally were compared with those of 20 ml 0.75% ropivacaine with adrenaline. Cardiovascular measurements were performed with a transthoracic electrical bioimpedance monitor. The maximum mean arterial blood pressure decrea...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1991.tb09544.x

    authors: Kerkkamp HE,Gielen MJ

    更新日期:1991-05-01 00:00:00

  • Effects of surgical stress and nitrous oxide anaesthesia on peri-operative plasma levels of total homocysteine. A randomised, controlled study in general surgery.

    abstract::Previous studies of patients have shown that anaesthesia with nitrous oxide (N2O) increases the plasma levels of total homocysteine. In a randomised, controlled trial we measured the plasma total homocysteine levels in patients undergoing general surgery before and after anaesthesia with and without N2O. Plasma total ...

    journal_title:Anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1046/j.1365-2044.2001.01374-2.x

    authors: Foschi D,Rizzi A,Zighetti ML,Bissi M,Corsi F,Trabucchi E,Mezzetti M,Cattaneo M

    更新日期:2001-07-01 00:00:00

  • The absence of teratogenic effects of some analgesics used in anaesthesia. Additional evidence from a mouse model.

    abstract::The possibility exists that agents used in anaesthesia may have adverse teratogenic effects on staff, patients, and developing fetuses. It has been shown that a range of neurotropic drugs, when injected into pregnant mice on the 9th day of gestation, produce a characteristic group of central nervous system malformatio...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1992.tb02267.x

    authors: Martin LV,Jurand A

    更新日期:1992-06-01 00:00:00

  • Prediction of prolonged laryngoscopy.

    abstract::Duration of laryngoscopy must be kept as short as possible to prevent disturbances of oxygenation and ventilation. Because the factors associated with prolonged laryngoscopy are not well known, we studied 1000 patients undergoing tracheal intubation under general anaesthesia to determine the possible effects of their ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1046/j.1365-2044.2001.02084-5.x

    authors: Saghaei M,Safavi MR

    更新日期:2001-12-01 00:00:00

  • Patient evaluation of four different combinations of intravenous anaesthetics for short outpatient procedures.

    abstract::We studied 200 female patients (ASA group 1) scheduled for termination of pregnancy under general anaesthesia. The patients were randomly allocated to receive one of four anaesthetic combinations; (1) propofol in combination with ketamine 20 mg, (2) propofol in combination with fentanyl 0.1 mg, (3) thiopentone in comb...

    journal_title:Anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.1993.tb07485.x

    authors: Jakobsson J,Oddby E,Rane K

    更新日期:1993-11-01 00:00:00

  • Meta-analysis on the effect of dopexamine on in-hospital mortality.

    abstract::The objective of the study was to determine whether dopexamine alters in-hospital mortality. The following databases were searched, Embase (1974-July 2007), Medline (1950-July 2007), CINAHL, PubMed and Cochrane Clinical Register of Controlled Trials (CENTRAL). Two reviewers independently checked the quality of the stu...

    journal_title:Anaesthesia

    pub_type: 杂志文章,meta分析,评审

    doi:10.1111/j.1365-2044.2009.05896.x

    authors: Gopal S,Jayakumar D,Nelson PN

    更新日期:2009-06-01 00:00:00

  • Bibliometric analysis of original molecular biology research in anaesthesia.

    abstract::Molecular biology has expanded the horizons of anaesthesia during the last 20 years and has led to an increase of basic science articles that are published in the specialised anaesthetic journals or originate in anaesthetic institutions. We searched for and analysed the specific features, such as year of publication, ...

    journal_title:Anaesthesia

    pub_type: 杂志文章,评审

    doi:10.1111/j.1365-2044.2004.03873.x

    authors: Schreiber K,Girard T,Kindler CH

    更新日期:2004-10-01 00:00:00

  • Addition of clonidine to a continuous patient-controlled epidural infusion of low-concentration levobupivacaine plus sufentanil in primiparous women during labour.

    abstract::We studied the potentiation of analgesia for labour by the addition of clonidine to epidural low-concentration levobupivacaine with sufentanil in a randomised, double-blinded study. We enrolled primiparous women who were in spontaneous labour. The study solutions, made of 100 ml levobupivacaine 0.0625% plus sufentanil...

    journal_title:Anaesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.2011.06785.x

    authors: Bazin M,Bonnin M,Storme B,Bolandard F,Vernis L,Lavergne B,Pereira B,Bazin JE,Dualé C

    更新日期:2011-09-01 00:00:00

  • A comparison of the Soft Seal disposable and the Classic re-usable laryngeal mask airway.

    abstract::Many new supraglottic airway devices have been recently introduced, their development motivated by the need for a single-use equivalent to the original re-usable laryngeal mask airway. We performed a randomised cross-over study in spontaneously breathing patients comparing the re-usable Laryngeal Mask Airway-Classic (...

    journal_title:Anaesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.2005.04461.x

    authors: Shafik MT,Bahlman BU,Hall JE,Ali MS

    更新日期:2006-02-01 00:00:00

  • A randomised comparison of the Portex Softseal laryngeal mask airway with the LMA-Unique during anaesthesia.

    abstract::We have compared the performance of the single use laryngeal airway devices Softseal and LMA-Unique in a randomised comparative trial in anaesthetised healthy patients who did not receive neuromuscular blockade. Primary outcome was success of airway placement. Secondary outcomes included manipulations and complication...

    journal_title:Anaesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.2005.04330.x

    authors: Cook TM,Trümpelmann P,Beringer R,Stedeford J

    更新日期:2005-12-01 00:00:00