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Intubation during spinal motion restriction using the Lubo TM cervical collar a minikin simulation study

Introduction: The Lubo TM collar is a cervical motion restriction device featuring a unique external jaw-thrust mechanism designed to provide non-invasive airway patency. In addition, tracheal intubation is facilitated by releasing an anterior chin strap; this allows better mouth opening than the pr...

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Main Author: Behari, Dinell
Other Authors: Hofmeyr, Ross
Format: Thesis
Language:English
Published: Department of Anaesthesia and Perioperative Medicine 2023
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access_status_str Open Access
author Behari, Dinell
author2 Hofmeyr, Ross
author_browse Behari, Dinell
Hofmeyr, Ross
author_facet Hofmeyr, Ross
Behari, Dinell
author_sort Behari, Dinell
collection Thesis
description Introduction: The Lubo TM collar is a cervical motion restriction device featuring a unique external jaw-thrust mechanism designed to provide non-invasive airway patency. In addition, tracheal intubation is facilitated by releasing an anterior chin strap; this allows better mouth opening than the previous generation of semi-rigid cervical collars. This study aimed to compare tracheal intubation using the Lubo TM collar combined with manual in-line stabilization (MILS) to intubation with MILS alone. The primary outcome was the time to successful intubation. Secondary outcomes compared intubation success rate, Cormack-Lehane grade, ease of intubation and dental trauma. Methods: A randomized, cross-over, equivalence study was performed. Eighty full-time physician anaesthesia providers were recruited. Participants performed tracheal intubation using direct laryngoscopy on a manikin under two different scenarios: with the Lubo TM collar and MILS applied, and with MILS and no cervical collar. The time to successful intubation was measured and compared using two-one-sided and paired t-tests. Results: Intubation times fell well within the a priori equivalence limits of 10 seconds, with a mean difference (95% CI) of 0.52 seconds (-1.30 to 2.56). There was no significant difference in intubation time with the Lubo TM collar (mean [SD] 19.2 [4.5] seconds) compared to the MILS alone group (19.7 [5.2] seconds). The overall success rate was 98.7% in the Lubo group and 100% in the MILS group. Adequate laryngoscopy views (Cormack-Lehane grades I to IIb) were equivalent between groups (Lubo 92.5% versus MILS alone 93.7%). Conclusion: In this manikin-based study, the time to intubation with the Lubo TM collar and MILS applied was equivalent to time to intubation with MILS alone, with similar intubating conditions. Thus, the Lubo TM collar and MILS may simplify airway management by reducing the number of steps required to perform intubation in patients requiring cervical motion restriction.
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institution University of Cape Town (South Africa)
language eng
last_indexed 2026-06-10T12:34:39.078Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2023
publishDateRange 2023
publishDateSort 2023
publisher Department of Anaesthesia and Perioperative Medicine
publisherStr Department of Anaesthesia and Perioperative Medicine
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source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/37417 Intubation during spinal motion restriction using the Lubo TM cervical collar a minikin simulation study Behari, Dinell Hofmeyr, Ross Anaesthesia and Perioperative Medicine Introduction: The Lubo TM collar is a cervical motion restriction device featuring a unique external jaw-thrust mechanism designed to provide non-invasive airway patency. In addition, tracheal intubation is facilitated by releasing an anterior chin strap; this allows better mouth opening than the previous generation of semi-rigid cervical collars. This study aimed to compare tracheal intubation using the Lubo TM collar combined with manual in-line stabilization (MILS) to intubation with MILS alone. The primary outcome was the time to successful intubation. Secondary outcomes compared intubation success rate, Cormack-Lehane grade, ease of intubation and dental trauma. Methods: A randomized, cross-over, equivalence study was performed. Eighty full-time physician anaesthesia providers were recruited. Participants performed tracheal intubation using direct laryngoscopy on a manikin under two different scenarios: with the Lubo TM collar and MILS applied, and with MILS and no cervical collar. The time to successful intubation was measured and compared using two-one-sided and paired t-tests. Results: Intubation times fell well within the a priori equivalence limits of 10 seconds, with a mean difference (95% CI) of 0.52 seconds (-1.30 to 2.56). There was no significant difference in intubation time with the Lubo TM collar (mean [SD] 19.2 [4.5] seconds) compared to the MILS alone group (19.7 [5.2] seconds). The overall success rate was 98.7% in the Lubo group and 100% in the MILS group. Adequate laryngoscopy views (Cormack-Lehane grades I to IIb) were equivalent between groups (Lubo 92.5% versus MILS alone 93.7%). Conclusion: In this manikin-based study, the time to intubation with the Lubo TM collar and MILS applied was equivalent to time to intubation with MILS alone, with similar intubating conditions. Thus, the Lubo TM collar and MILS may simplify airway management by reducing the number of steps required to perform intubation in patients requiring cervical motion restriction. 2023-03-13T13:51:17Z 2023-03-13T13:51:17Z 2022 2023-02-20T12:17:15Z Master Thesis Masters MMed http://hdl.handle.net/11427/37417 eng application/pdf Department of Anaesthesia and Perioperative Medicine Faculty of Health Sciences
spellingShingle Anaesthesia and Perioperative Medicine
Behari, Dinell
Intubation during spinal motion restriction using the Lubo TM cervical collar a minikin simulation study
thesis_degree_str Master's
title Intubation during spinal motion restriction using the Lubo TM cervical collar a minikin simulation study
title_full Intubation during spinal motion restriction using the Lubo TM cervical collar a minikin simulation study
title_fullStr Intubation during spinal motion restriction using the Lubo TM cervical collar a minikin simulation study
title_full_unstemmed Intubation during spinal motion restriction using the Lubo TM cervical collar a minikin simulation study
title_short Intubation during spinal motion restriction using the Lubo TM cervical collar a minikin simulation study
title_sort intubation during spinal motion restriction using the lubo tm cervical collar a minikin simulation study
topic Anaesthesia and Perioperative Medicine
url http://hdl.handle.net/11427/37417
work_keys_str_mv AT beharidinell intubationduringspinalmotionrestrictionusingthelubotmcervicalcollaraminikinsimulationstudy