Intubation
Conditions
Brief summary
This study hypothesizes that a novel reversal V-E ventilation technique will retain its high efficiency as that of standard V-E technique and will be easier to use.
Detailed description
Despite advances in intubation technology, difficult airways persist. Because it is failure to oxygenate, not failure to intubate, that ultimately leads to brain injury and cardiovascular collapse, effective mask ventilation is at least as important as successful intubation. Therefore optimizing mask ventilation is crucial for clinicians. When difficult mask ventilation encounters, clinicians often switch to two hand technique to hold the mask including either C-E clamp or V-E clamp. Both volume mode ventilation and pressure mode ventilation are superior with the V-E technique as compared to the C-E technique. The study will test the hypothesis that a novel reversal V-E mask ventilation technique will retain its high efficiency as that of standard V-E technique but be easier to use than standard V-E technique.
Interventions
PROCEDUREStandard V-E ventilation technique
For the two-handed standard V-E technique, the facemask is first placed over the bridge of the nose and mouth and then held in place by performing at two-handed jaw thrust maneuver with the index and second finger of each hand and maintaining mask contact with the patient's face by using both thumbs with mouth open. A head-tilt is performed by applying a caudal force on the mandible and mask.
PROCEDUREReversal V-E ventilation technique
While using reversal V-E technique, the anesthesia provider stands 180 degrees opposite from the head of the bed. Thenar eminence and thumbs secure the mask around the nose while the remaining fingers pull the mandible anteriorly while keeping the mouth open.
Sponsors
Vanderbilt University Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Intervention model description
Comparison of 2 two-handed mask ventilation techniques' ease to anesthesia providers
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Over 18 years of age * Requiring general anesthesia * BMI =\>30
Exclusion criteria
* Untreated ischemic heart diseases * Respiratory disorders, including COPD and asthma * American Society of Anesthesiologists(ASA) physical class of 4 or greater * Undergoing emergency surgery * Requiring rapid sequence intubation for aspiration protection * Non propofol - induction of anesthesia * Requiring fiberoptic intubation * Pregnant women or women who have given birth within the last month
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual score of friendliness of mask holding technique using 11 point scale | Conclusion of masked ventilation (approximately 5 minutes) | Visual score of friendliness of mask holding technique using 11 point scale when 0 is easy and 10 is difficult. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| AUC of exhaled tidal volume (Vt) trace | Period of masked ventilation (approximately 5 minutes) | Comparison of AUC of exhaled tidal volume trace |
| Vt/AUC | Period of masked ventilation (approximately 5 minutes) | Vt/AUC of exhaled Vt |
| Peak inspiratory airway pressure | Period of masked ventilation (approximately 5 minutes) | Peak inspiratory airway pressure |
Countries
United States
Outcome results
None listed