An exploratory study of the McKay airway to assist bag-mask ventilation
- PDF / 319,179 Bytes
- 2 Pages / 595.276 x 790.866 pts Page_size
- 61 Downloads / 197 Views
CORRESPONDENCE
An exploratory study of the McKay airway to assist bag-mask ventilation William P. McKay, MD . Udoka Okpalauwaekwe, MD . Cuylar Conly, MSc . Bhavna Pooni, RN, BSN
Received: 27 January 2020 / Revised: 21 April 2020 / Accepted: 24 April 2020 Ó Canadian Anesthesiologists’ Society 2020
To the Editor, We recently described a novel oral airway device, the McKay airway, designed for maintenance of jaw thrust (Figure 1) by first responders performing bag-mask ventilation (BMV).1,2 When infrequently performed, BMV is generally not done well.3,4 With University of Saskatchewan ethics approval (#1324; 17 July 2019), we compared the time for naı¨ve learners to achieve target exhaled tidal volume (VE) [ 300 mL during BMV on anesthetized patients using either a Guedel or McKay airway.5 The order-randomized cross-over study (performed from 1 August to 18 December 2019) enrolled 31 consenting learners (medical students, non-anesthesia residents, and other naı¨ve learners scheduled in the operating rooms to be taught airway management) who performed BMV on one
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12630-020-01696-3) contains supplementary material, which is available to authorized users. W. P. McKay, MD (&) Department of Anesthesia, University of Saskatchewan, Saskatoon, SK, Canada e-mail: [email protected] U. Okpalauwaekwe, MD Division of Cardiology, University of Saskatchewan, Saskatoon, SK, Canada C. Conly, MSc University of Saskatchewan College of Medicine, Saskatoon, SK, Canada B. Pooni, RN, BSN Faculty, Perioperative Services and Medical Device Reprocessing, Saskatchewan Polytechnic Institute, Saskatoon, SK, Canada
or more patients. Consenting adults undergoing elective surgery under general anesthesia were recruited. Exclusion criteria included temporomandibular joint disorders, loose incisors, reflux, and a attending anesthesiologist’s opinion of any added patient risk for participation. For edentulous patients, we padded the McKay airway surface with a 1-cm thick stick-on sponge (RestonTM Self-Adhering Foam Pads; 3 M, Maplewood, MN, USA). Following induction of anesthesia and initial BMV by the attending anesthesiologist, an opaque numbered envelope was opened to randomly assign which airway was to be used first. We simulated a self-inflating BMV device by setting the adjustable pressure limit valve on the anesthetic machine to [ 30 cm water pressure and using the oxygen flush to ensure that the reservoir bag was filled between breath attempts. After the airway was inserted, learners applied the mask with their left hand, squeezing the bag with their right approximately every three seconds. The time was recorded from the first bag squeeze until the primary outcome of a VE [ 300 mL was reached. The first airway was then removed and replaced with the alternate airway and the procedure repeated. The anesthesiologist’s intervention (if needed) and comments were recorded. Time measurement differences that were non-normally distributed were analysed
Data Loading...
