RESUMEN
BACKGROUND: Airway management in the emergency department is a critical intervention that requires both standard techniques and rescue techniques to ensure a high rate of success. Recently, video laryngoscope (VL) systems have become increasingly common in many large urban Eds, but these systems may exceed the budgets of smaller rural Eds and EMS services and the Airtraq optical laryngoscope (OL) may provide an effective, low-cost alternative. We hypothesized that laryngeal view and time to endothracheal tube placement for OL and VL intubations would not be significantly different. METHODS: This was a prospective, crossover trial. Setting: University-based emergency medicine residency program procedure laboratory utilizing lightly embalmed cadavers. Subjects:PGY1-3 emergency medicine residents. The study subjects performed timed endotracheal intubations alternately using the OL and VL. The subjects then rated the Cormack-Lehane laryngeal view for each device. Statistical analysis: Mean time to intubation and the mean laryngeal view score were calculated with 95％ confidence intervals and statistical significance was determined by Student's t test. RESULTS: Fourteen subjects completed the study. The average laryngeal view achieved with the OL vs. the VL was not significantly different, with Cormack-Lehane grade of 1.14 vs. 1.07, respectively. Time to endotracheal intubation, however, was significantly different (P<0.001) with the average time to intubation for the OL 25.49 seconds (95％ CI: 17.95-33.03) and the VL 13.41 seconds (10.27-16.55). CONCLUSION: The Airtraq OL and the Storz VL yielded similar laryngeal views in the lightly embalmed cadaver model. Time to endotracheal tube placement, however, was less for the VL.
RESUMEN
BACKGROUND: Macintosh laryngoscopic intubation is a lifesaving procedure, but a difficult skill to learn. The Airtraq optical laryngoscope (AOL) is a novel intubation device with advantages over the direct laryngoscope for untrained personnel in a manikin study. We compared the effectiveness of AOL with Macintosh laryngoscope for tracheal intubation by novice personnel. METHODS: We selected 37 medical students with no prior tracheal intubation experience and educated them on using both laryngoscopes. Seventy-four patients were randomly divided into two groups (group A: AOL, group M: Macintosh laryngoscope). We recorded the tracheal intubation success rate, intubation time, number of attempts, intubation difficulty scale, and adverse effects. RESULTS: The total success rate was similar in the two groups, but the success rate at first attempt was higher in group A (P < 0.01). Group A also showed reduced duration and attempts at intubation, as well as adverse effects such as oral cavity injury. Additionally, participant reports indicated that using the AOL was easier than the Macintosh laryngoscope (P < 0.01). CONCLUSIONS: The AOL is a more effective instrument for tracheal intubation than Macintosh laryngoscope when used by novice personnel.