Cuffed oropharyngeal airway (COPA) placement is delayed by wearing antichemical protective gear
Prehospital care
R Ben-Abraham1,
R Flaishon1,
A Sotman1,
T Ezri2,
M Weissenberg2,
A A Weinbroum1,3
Department of Anesthesia and CCM, Tel Aviv Sourasky Medical Centre, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Department of Anesthesia, Edith Wolfson Medical Centre, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Post-Anaesthesia Care Unit, Tel Aviv Sourasky Medical Centre, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Professor A A Weinbroum, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, Tel Aviv 64239, Israel; draviw{at}tasmc.health.gov.il
Background: Airway management, the first step in resuscitation, may entail special difficulties in mass casualty situations, even in experienced hands. Of the available airway devices, the cuffed oropharyngeal airway (COPA) appears the easiest one to insert, allowing a hands-free anaesthesiologist. A study was undertaken to evaluate the success of airway control with COPA when anaesthetists wore either surgical attire or antichemical protective gear.
Methods: Twelve anaesthetists with 2–5 years of residency inserted COPA in 24 anaesthetised patients in a random crossover prospective manner. The duration of airway management was measured from the time the device was grasped to obtaining a normal capnography recording; time to proper fixation was also recorded.
Results: Time to COPA placement was significantly shorter when the anaesthetists wore surgical attire than when they wore protective gear (28 (10) s vs 56 (34) s, p<0.05). Time to proper fixation of the COPA to patients' faces also differed significantly (19 (14) s with surgical attire vs 34 (16) s with protective gear, p<0.05). First-time COPA insertion failure was statistically similar in both groups. There was no hypoxaemia.
Conclusions: Antichemical protective gear slowed proper placement of COPA and its fixation compared with surgical attire. COPA may be a temporarily useful device in non-conventional settings, but functional reassessment is required when injured patients reach medical facilities.
Ethics approval: The study was approved by the institutional human investigation committee and all participants signed an informed consent form approved by the Helsinki Committee after having been given a detailed explanation of the study.