Abstract 102: Randomized Comparison Of The Airway Scope And The Macintosh Laryngoscope For The Tracheal Intubation In Manikin Study
[Background] Failed or difficult tracheal intubation is an important case of morbidity and mortality during emergency. However, conventional direct laryngoscope is a difficult skill, and proficiency deteriorates over time if it is not regularly clinical practice. The Airway Scope (AWS, Pentax, Tokyo, Japan) is a novel intubation device, which allows visualization vocal cods without alignment of the oral, pharyngeal and tracheal axes. We hypothesized that, in the hands of poor laryngoscopists, a like of residents, the AWS would prove equal or superior to the Macintosh laryngoscope (ML) in the normal and simulated difficult airway.
[Methods] Designs: Cross-over trial in manikin study. Participants: 34 residents (female: 4, mean age: 29 yo) in Cardiology and Internal medicine were attempted to intubate to the trachea in each seven scenarios using a Laerdal AirMan. Intervention: group A: the first procedures using the AWS and then the second procedures using the ML, group B: the first procedures using the ML and the second procedures using the AWS. Outcomes: The primary outcome was successful to intubate in normal scenario. The secondary outcomes were successful in difficulty 6 scenarios, and elapsed times for each procedure and dental trauma of intubation in all scenarios.
[Result] In normal scenario, all intubations using the AWS were successfully finished and one intubation using the ML was failed. The AWS (max-min: 4.68 –29.34 sec, median 12.3 sec) was superior to the ML (max-min: 5.49 –51.51 sec, median 12 sec) in successful time (log rank test P = 0.05). AWS had less frequency of dental trauma than the ML (P < 0.01).
[Conclusions] In the simulated airway scenarios, the AWS was more successful in achieving tracheal intubation, required less time to intubate successfully comparing with the ML. Those findings suggest that the AWS is an alternative airway management in the situations, which need an advanced airway to minimize complications and interruption of chest compressions.