Is digital intubation an option for emergency physicians in definitive airway management?

This study was designed to determine whether digital intubation is a valid option for definitive airway control by emergency physicians. Digital intubation was performed by 18 emergency medicine residents and 4 staff emergency medicine physicians on 6 different cadavers. Placement was confirmed by d...

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Bibliographic Details
Published in:The American journal of emergency medicine 2006-10, Vol.24 (6), p.729-732
Main Authors: Young, Scott E., Miller, Michael A., Crystal, Chad S., Skinner, Carl, Coon, Troy P.
Format: Article
Language:English
Subjects:
Aged
Airway management
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Cadaver
Clinical Competence
Confidence intervals
Emergency and intensive care: techniques, logistics
Emergency and intensive respiratory care
Emergency medical care
Emergency Medicine - education
Emergency Service, Hospital
Female
Hospitals
Humans
Intensive care medicine
Intensive care unit. Emergency transport systems. Emergency, hospital ward
Intubation
Intubation, Intratracheal - methods
Laryngoscopy
Larynx
Male
Medical sciences
Medicine
Methods
Physicians
Pilot Projects
Prospective Studies
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Summary:This study was designed to determine whether digital intubation is a valid option for definitive airway control by emergency physicians. Digital intubation was performed by 18 emergency medicine residents and 4 staff emergency medicine physicians on 6 different cadavers. Placement was confirmed by direct laryngoscopy. The total time for all attempts used, as well as the number of attempts, was recorded. Each participant attempted intubation on all 6 cadavers. For 5 of the 6 cadavers, successful intubation occurred 90.9% of the time (confidence interval [CI], 85.5%-96.3%) for all participants. The average number of attempts for these 5 cadavers was 1.5 (CI, 1.4-1.7), and the average time required for success or failure was 20.8 seconds (CI, 16.9-24.8). The sixth cadaver developed soft tissue damage and a false passage near the vocal cords resulting in multiple failed attempts. Although the gold standard for routine endotracheal intubation remains to be direct laryngoscopy, its effectiveness in certain situations may be limited. We believe that digital intubation provides emergency physicians with another option in securing the unprotected airway.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2006.03.001