Soiled Airway Tracheal Intubation and the Effectiveness of Decontamination by Paramedics

Yorkshire Ambulance Service NHS Trust164 enrolled

Overview

In more than one-in-five cases of out-of-hospital cardiac arrest, airways are blocked by vomit and blood. Sometimes, paramedics cannot clear the airway using methods they have been taught. If the airway cannot be cleared, the patient will die. Usually, these patients will have a breathing tube placed into their windpipe (intubation), as this provides protection from vomit and blood. To do this, the paramedic needs to be able to see the entrance to the windpipe. A new method of clearing the airway called SALAD has been used in patients to help insert a breathing tube, but it is not known whether the method can help paramedics. This study will use a manikin to see if paramedics can insert a breathing tube more often on their first attempt, using SALAD.

Study Type

OBSERVATIONAL

Enrollment

164

Conditions

Airway Management Intubation, Intratracheal Laryngoscopy Vomiting

Interventions

The training session will be delivered, and will take around 45 minutes to complete, including time for participant practice. The training intervention will adopt the Advanced Life Support Group/Resuscitation Council 4-stage approach of skills teaching, and is comprised of: A real-time demonstration of the SALAD technique by the researcher; A repeated demonstration with an explanation of the rationale of the steps taken when performing SALAD (not real-time); Another demonstration of the SALAD technique conducted by the researcher, but guided by one of the participants; An attempt by the same participant who guided the researcher in the previous step, followed by a practice attempt by the other participants.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Aged 18 and over * HCPC registered paramedic employed by Yorkshire Ambulance Service * Authorised to intubate within Yorkshire Ambulance Service * No SALAD training in the last 3 months Exclusion Criteria: * Not an HCPC registered paramedic employed by Yorkshire Ambulance Service * Not authorised to intubate within Yorkshire Ambulance Service * Allergy to artificial 'vomit' ingredients * Unwilling to provide consent * SALAD training in the last 3 months

Outcomes

Primary Outcomes

Difference in First-pass Intubation Success Rates Before and After SALAD Training

This measure is a comparison of Group AAB's first-pass intubation success rate, using an attempt which occurred before SALAD training, and Group ABB's intubation success rate, using an intubation attempt that occurred after SALAD training.

Time frame: pre- and post-training as part of 2 hour study session

Secondary Outcomes

Difference Between Mean Time Taken (in Seconds) to Perform a Successful Intubation on the First- Attempt, Before and After SALAD Training Approximately 30 Minutes Apart.

Time frame: seconds

Difference in Success Rates Between Participants Who Have Two Post-training Intubation Attempts Versus Participants Who Only Have One Post-training Intubation Attempt