Figure 1 - uploaded by Per Kristian Hyldmo
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The lateral trauma position. A patient has been positioned in the lateral trauma position on a stretcher. Observe that the most cephalic stretcher belt has been placed above the shoulder to prevent forward movement on the stretcher.
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Citations
... However, the method has been used in real-life situations where normal attempts for intubation failed, with immediate success. In the case of sudden regurgitation, the method can be performed immediately, without any need for equipment or extra preparation, and the position gives some protection from aspiration until the airway is secured [32]. In cases where ETI in the semiprone position fails, return to the supine position can be performed within seconds. ...
Background:
Endotracheal intubation of patients with massive regurgitation represents a challenge in emergency airway management. Gastric contents tend to block suction catheters, and few treatment alternatives exist. Based on a technique that was successfully applied in our district, we wanted to examine if endotracheal intubation would be easier and quicker to perform when the patient is turned over to a semiprone position, as compared to the supine position.
Methods:
In a randomized crossover simulation trial, a child manikin with on-going regurgitation was intubated both in the supine and semiprone positions. Endpoints were experienced difficulty with the procedure and time to intubation, as well as visually confirmed intubation and first-pass success rate.
Results:
Intubation in the semiprone position was significantly easier and faster compared to the supine position; the median experienced difficulty on a visual analogue scale was 27 and 65, respectively (p = 0.004), and the median time to intubation was 26 and 45 s, respectively (p = 0.001). There were no significant differences in frequency of visually confirmed intubation (16 and 18, p = 0.490) of first-pass success rate (17 and 18, p = 1.000).
Conclusion:
In this experiment, endotracheal intubation during massive regurgitation with the patient in the semiprone position was significantly easier and quicker to perform than in the supine position. Endotracheal intubation in the semiprone position can provide a quick rescue method in situations where airway management is hindered by massive regurgitation, and it represents a possible supplement to current airway management training.
