Article

Emergency tracheal intubation using the Airtraq laryngoscope during chest compression

126 Correspondence

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Emergency tracheal intubation using the Airtraq laryngoscope during chest compressionB

To the Editor,

We read with interest the correspondence of Corso et al

[1] regarding the Airtraq laryngoscope (ATQ) for emergency tracheal intubation without interruption of chest compression in a 61-year-old patient presented to their medical emergency team for in-hospital cardiac arrest in radiology suite. The authors should be congratulated on their successful airway management using the ATQ in this emergency case. However, we would like to highlight one disputable point with respect to the tracheal intubation with the ATQ during chest compression.

In a recent manikin study, Koyama et al [2] found that during chest compressions, 7 of 35 examinees failed in the tracheal intubation with the ATQ, and intubation time was significantly longer with the ATQ than with the Pentax-AWS or Macintosh laryngoscope. Probable reason of the failed intubation with the ATQ is that movement of the head by chest compression can make difficult to observe the larynx through the device, as the intubators have to bring the eye close to the device to observe. Therefore, when emergency tracheal intubation is performed with the ATQ during chest compression, we recommend using an Airtraq video camera, which easily clips on and off the proximal viewfinder of the ATQ and transmits to a display via a lightweight cable. It allows viewing and recording the process of laryngoscopy and intubation with the ATQ when connected to external medical grade monitor. In addition, there is also commer- cially Airtraq wireless monitor, which can automatically receive and display the images from Airtraq video camera by radiofrequency at 2.4 GHz (open frequency; available at

? All authors have no financial support and potential conflicts of interest for this work.

http://www.kingsystems.com/Portals/1/AIRTRAQLIT67. pdf). By these video devices, the ATQ may function as a videolaryngoscope. As with the Pentax-AWS, moreover, the ATQ has a tube guiding channel. This may make the glottis and endotracheal tube to move simultaneously during chest compressions because of the assembly of the ATQ and endotracheal tube. In this way, the relative position of the glottis and endotracheal tube does not change, leading to an easy and safe intubation during chest compressions [3,4].

Fu-Shan Xue MD Yu-Jing Yuan MD Qiang Wang MD Jun Xiong MD

Xu Liao MD Department of Anesthesiology plastic surgery Hospital

Chinese Academy of Medical Sciences and Peking Union Medical College Shi-Jing-Shan District

Beijing 100144 People’s Republic of China

E-mail address: [email protected] doi:10.1016/j.ajem.2010.09.012

References

  1. Corso RM, Piraccini E, Agnoletti V, Gambale G. The Airtraq laryngoscope for emergency tracheal intubation without interruption of chest compression. Am J Emerg Med 2010;28:971-2.
  2. Koyama J, Iwashita T, Okamoto K. Comparison of three types of laryngoscope for tracheal intubation during rhythmic chest compres- sions: a manikin study. Resuscitation 2010;81:1172-4.
  3. Han SK, Shin DH, Choi PC. Utility of the Pentax-AWS without interruption of chest compression: comparison of the Macintosh laryngoscope with the Pentax-AWS in manikin model. Resuscitation 2010;81:69-73.
  4. Komasawa N, Ueki R, Nomura H, Itani M, Kaminoh Y. Comparison of tracheal intubation by the Macintosh laryngoscope and Pentax-AWS (airway scope) during chest compression: a manikin study. J Anesth 2010;24:306-8.

Comments on tracheal intubation using Macintosh and video laryngoscopes during chest compressions

To the Editor,

We were greatly interested in the recent article of Kim et al [1] regarding the tracheal intubation using Macintosh and video laryngoscopes with and without chest compres- sions in a Mannequin study. Their findings showed that chest compressions did not significantly affect the tracheal intubation with the Macintosh laryngoscope , Glide- Scope (GVL), and Airway Scope (AWS) by Experienced intubators. Also, there were no significant differences in the

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