Successful one-lung ventilation using the VivaSight-EB bronchial blocker tube for an emergency lung injury. A simulation pilot data

Abstract

INTRODUCTION: The ability to perform endotracheal intubation is one of the basic skills that paramedics should demonstrate. However, in some cases where lung or bronchial injuries have occurred, it may be necessary to separate the lung by attaching a bronchial blocker and ventilating single lung. The aim of the study was to evaluate the effectiveness of bronchial protection with VivaSight-EB bronchial blocker tube and one-lung ventilation by paramedics in conditions of simulated lung injury. MATERIAL AND METHODS: The study was a prospective randomized cross-over simulation trial in which 27 paramedics took part. In the study, paramedics performed endotracheal intubation with ETView SL and then introduced a VivaSight-EB bronchial blocker and one-lung ventilation. The bronchial protection procedure took place in two scenarios: (A) normal airway; (B) difficult airway. VivaSight-EB bronchial blocker introduction time (T1) and one-lung ventilation time (T2) and the efficacy of the procedure were analysed. RESULTS: The efficacy of endotracheal intubation with ETView SL tube was 100% during both Scenario A and Scenario B. The efficacy of endotracheal intubation with ETView SL tube was 100%. The effectiveness of the first attempt to protect the bronchi with a bronchial blocker was 26% for both scenarios and the total effectiveness of bronchial protection was 100% in both cases. Time T1 for endotracheal intubation was 18sec for Scenario A (IQR; 16.5–25) and 20 sec for Scenario B (IQR; 17–25). The time to perform one-lung ventilation (Time T2) in scenarios A and B was 43 sec (IQR; 38–62.5) vs. 43.5 sec (38–65). CONCLUSIONS: The simulation study confirmed the research hypothesis that the paramedics were able to perform one-lung ventilation using the ETView-Blocker® bronchial blocker tube after a short training.