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Comparison of the application of laryngeal mask airway and endotracheal tube in hospital emergency

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Author : Joe Wong
Update time : 2020-12-31 10:53:45
Comparison of the application of laryngeal mask airway and endotracheal tube in hospital emergency

Objective: To explore the application value of laryngeal mask airway in first aid in hospital.

Methods: Select 40 emergency patients in hospital and randomly divide them into LMA group and endotracheal tube group. In the past, the first aid was tracheal intubation. Due to the direction of the patient's bed and the patient's position, the difficulty of emergency tracheal intubation is very difficult, the success rate is not high, and the family members are present, repeated operation failures delay the rescue opportunity, and cause family dissatisfaction. With the improvement of the equipment conditions of the anesthesia department and the continuous updating of anesthesia intubation equipment in clinical anesthesia, the laryngeal mask has been used in clinical first aid for many years. Results The difficulty of the combined tracheal intubation group in the first aid process, the time required for the operation, the success rate of one-time intubation or laryngeal mask placement, and the success rate of resuscitation were significantly different.

1. Traditional tracheal intubation emergency: It is common to have teeth falling off or broken when the laryngoscope is inserted, the lips and throat mucosa are bruised and bleeding, the upper incisor and the supporting point of the laryngoscope are too strong, which will easily loosen the upper incisor and cause it to fall off. Especially in acute elderly patients, when the glottis is exposed, the front end of the lens is easy to squeeze the mucosa of the pharyngeal cavity, causing injury or bleeding, and repeated intubation can also easily cause laryngeal edema
2. Laryngeal mask airway emergency: Laryngeal mask airway is a new way of ventilation between the tracheal intubation and the face mask. Compared with the fully embedded method of tracheal intubation, its semi-embedded type provides good ventilation and is easier Tolerance. It has the characteristics of low cardiovascular response, no need for laryngoscope to expose the glottis during insertion, safe, effective, and easy to place. It is officially used in hospital first aid.
First aid method: Choose the respiratory and circulatory arrest for non-severe organic disease within 5 minutes, the main manifestation is the sudden loss of consciousness, the stop of breathing, and the disappearance of the pulse of the aorta. Quick and accurate judgment of respiratory and circulatory arrest is the key to successful resuscitation. What equipment is used for first aid is the key to successful rescue, so the phrase "time is life" is most appropriate here. Select patients with no stomach, no vomiting, and no airway obstruction to insert a laryngeal mask; select patients with unclear causes of respiratory and circulatory arrest for tracheal intubation. However, the two sets of implantation methods all face masks for 2-3 minutes to supply oxygen and discharge nitrogen with pure oxygen, that is, pre-oxygenation state.
            Table I Comparison of patient placement time
    Group    Time (S)   One-time success rate
  LMA 43+/-10 100
  ET  180+/-28.5 30

Table II Resuscitation success rate of two groups of patients
Group  Resuscitation rate (%)
LMA  35
ET 10

Conclusion: This experiment shows that oral foreign bodies need to be removed when the laryngeal mask airway or endotracheal tube is inserted. The effect of tracheal intubation is the most accurate and can avoid aspiration. However, the time required for intubation is long and the one-time success rate is not high. Affected by the patient's ward conditions, body position and other factors, repeated operations and repeated oxygen inhalation for more than 10 minutes may easily cause laryngeal edema, airway damage, increase the difficulty of resuscitation, and delay rescue time. The operation of the laryngeal mask is simple, fast and safe, with a one-time success rate of 100%, which can effectively reduce the occurrence of airway complications and effectively avoid airway damage caused by tracheal intubation.