CobraPLA™ insertion by anesthetists and non-anesthetists wearing unconventional protective gear: A prospective study in humans

Ron Ben-Abraham, Ron Flaishon, Alexander Sotman, Perla Ekstein, Tiberiu Ezri, Daniel Ogorek, Avi A. Weinbroum

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The threat of a mass casualty unconventional attack has challenged the medical community to devise means for providing rapid and reliable emergent airway control under chaotic conditions by inexperienced medical personnel dressed in self protective gear. Since endotracheal intubation may not be feasible under those conditions, other extraglottic devices should be considered. We assessed the performance of anesthesia and non-anesthesia residents in inserting the CobraPLA™, a supraglottic airway device, on consecutive anesthetized patients, to assess its potential use under simulated conditions. Material/Methods: Anesthesia and non-anesthesia residents wearing either surgical scrubs or complete anti-chemical gear inserted the CobraPLA™ in anesthetized patients. If post-trial positive pressure ventilation via the CobraPLA™ was unsuccessful, an LMA™ or endotracheal tube was inserted in its stead. Results: It took anesthesia resident 57±23 sec and 43±13 sec (P<0.05) to place the CobraPLA™while wearing anti-chemical gear and surgical scrubs, respectively. Non-anesthesia residents wearing anti-chemical gear performed worse than anesthetists in their first insertion (73±9 sec, P<0.05), but after the brief training period they performed as well as their colleagues anesthetists (58±10 sec, P=NS). Post-trial, twenty-one CobraPLA™ (42%) leaked, preventing adequate positive-pressure ventilation: 13 devices (26% of the total) required replacements. Conclusions: Anti-chemical protective gear slowed the insertion of the CobraPLA™ by anesthetists, and more so by other residents inexperienced in airway management. In 26% of the cases CobraPLA™was inadequate for positive pressure ventilation.

Original languageEnglish
Pages (from-to)PI13-PI18
JournalMedical Science Monitor
Volume14
Issue number7
StatePublished - Jul 2008

Keywords

  • Airway management
  • Cobrapla™
  • Unconventional protective gear

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