TY - JOUR
T1 - Tracheal intubation during chest compressions performed by qualified emergency physicians unfamiliar with the Pentax-Airwayscope
AU - Shin, Dong Hyuk
AU - Han, Sang Kuk
AU - Choi, Pil Cho
AU - Sim, Min Seob
AU - Lee, Jeong Hun
AU - Park, Sang O.
PY - 2013/6
Y1 - 2013/6
N2 - OBJECTIVE: Experienced emergency physicians were recruited and a randomized crossover trial was conducted to compare the performance of the Pentax-Airwayscope (AWS) video-laryngoscope with the Macintosh laryngoscope (McL) for tracheal intubation during continuous chest compressions under three different scenarios: (1) normal airway, (2) limited neck mobility, and (3) tongue edema. METHODS: Thirty-six experienced emergency physicians performed intubations on a manikin in each of three scenarios. The sequences of scenarios and intubating devices were randomized. Time to complete intubation (primary end point), time to visualization of the vocal cords, the overall success rate, percentage of glottic opening, dental compression, and ease of intubation were determined. RESULTS: The times (median [interquartile range]) to complete tracheal intubation were significantly shorter with the AWS than the McL in all three scenarios (11.6 [8.0-14.7] vs. 15.1 [12.8-17.9] s, 13.5 [10.5-20.9] vs. 17.0 [14.1-19.9] s, and 13.6 [11.1-20.9] vs. 15.1 [18.6-37.5] s, respectively). The overall success rates were higher with the AWS than the McL in the difficult intubation scenario (77.8 vs. 100%). The AWS was also more effective than the McL with respect to the percentage of glottic opening, dental compression, and ease of intubation in all three scenarios. CONCLUSION: Although participants were experienced emergency physicians familiar with the McL and unfamiliar with the AWS, the AWS proved to be a better tool than the McL to perform tracheal intubation during continuous chest compressions on a manikin. The AWS should be considered as an initial intubating tool to perform tracheal intubation during continuous chest compressions rather than the McL.
AB - OBJECTIVE: Experienced emergency physicians were recruited and a randomized crossover trial was conducted to compare the performance of the Pentax-Airwayscope (AWS) video-laryngoscope with the Macintosh laryngoscope (McL) for tracheal intubation during continuous chest compressions under three different scenarios: (1) normal airway, (2) limited neck mobility, and (3) tongue edema. METHODS: Thirty-six experienced emergency physicians performed intubations on a manikin in each of three scenarios. The sequences of scenarios and intubating devices were randomized. Time to complete intubation (primary end point), time to visualization of the vocal cords, the overall success rate, percentage of glottic opening, dental compression, and ease of intubation were determined. RESULTS: The times (median [interquartile range]) to complete tracheal intubation were significantly shorter with the AWS than the McL in all three scenarios (11.6 [8.0-14.7] vs. 15.1 [12.8-17.9] s, 13.5 [10.5-20.9] vs. 17.0 [14.1-19.9] s, and 13.6 [11.1-20.9] vs. 15.1 [18.6-37.5] s, respectively). The overall success rates were higher with the AWS than the McL in the difficult intubation scenario (77.8 vs. 100%). The AWS was also more effective than the McL with respect to the percentage of glottic opening, dental compression, and ease of intubation in all three scenarios. CONCLUSION: Although participants were experienced emergency physicians familiar with the McL and unfamiliar with the AWS, the AWS proved to be a better tool than the McL to perform tracheal intubation during continuous chest compressions on a manikin. The AWS should be considered as an initial intubating tool to perform tracheal intubation during continuous chest compressions rather than the McL.
KW - cardiopulmonary resuscitation
KW - heart massage
KW - intratracheal intubation
KW - manikin
UR - http://www.scopus.com/inward/record.url?scp=84877029956&partnerID=8YFLogxK
U2 - 10.1097/MEJ.0b013e328354f6c4
DO - 10.1097/MEJ.0b013e328354f6c4
M3 - Article
C2 - 22609723
AN - SCOPUS:84877029956
SN - 0969-9546
VL - 20
SP - 187
EP - 192
JO - European Journal of Emergency Medicine
JF - European Journal of Emergency Medicine
IS - 3
ER -