Abstract
Objective
The aim of the trial was to compare the time parameters for intubation with the use
of the Macintosh (MAC) laryngoscope and Pentax AWS-S100 videolaryngoscope (AWS; Pentax
Corporation, Tokyo, Japan) with and without chest compression (CC) by paramedics during
simulated cardiopulmonary resuscitation in a cadaver model.
Methods
This was a randomized crossover cadaver trial. Thirty-five paramedics with no experience
in videolaryngoscopy participated in the study. They performed intubation in two emergency
scenarios: scenario A, normal airway without CC; scenario B, normal airway with continuous
CC.
Results
The median time to first ventilation with the use of the AWS and the MAC was similar
in scenario A: 25 (IQR, 22-27) seconds vs. 24 (IQR, 22.5-26) seconds (P = .072). A statistically significant difference in TTFV between AWS and MAC was noticed
in scenario B (P = .011). In scenario A, the first endotracheal intubation (ETI) attempt success rate
was achieved in 97.1% with AWS compared with 94.3% with MAC (P = .43). In scenario B, the success rate after the first ETI attempt with the use of
the different intubation methods varied and amounted to 88.6% vs. 77.1% for AWS and
MAC, respectively (P = .002).
Conclusions
The Pentax AWS offered a superior glottic view as compared with the MAC laryngoscope,
which was associated with a higher intubation rate and a shorter intubation time during
an uninterrupted CC scenario. However, in the scenario without CC, the results for
AWS and MAC were comparable.
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References
- European resuscitation council guidelines for resuscitation 2015: section 3. Adult advanced life support.Resuscitation. 2015; 95: 100-147https://doi.org/10.1016/j.resuscitation.2015.07.016
- Part 7: adult advanced cardiovascular life support: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care.Circulation. 2015; 132: S444-S464https://doi.org/10.1161/CIR.0000000000000261
- A comparison of the McGrath-MAC and Macintosh laryngoscopes for child tracheal intubation during resuscitation by paramedics. A randomized, crossover, manikin study.Am J Emerg Med. 2016; 34 ([pii: S0735–6757(15)01038–4]): 1338-1341https://doi.org/10.1016/j.ajem.2015.11.060
- Airway Management of Respiratory Failure.Emerg Med Clin North Am. 2016; 34: 97-127https://doi.org/10.1016/j.emc.2015.08.007
- Can the ETView VivaSight SL rival conventional intubation using the Macintosh laryngoscope during adult resuscitation by novice physicians?: a randomized crossover manikin study.Medicine (Baltimore). 2015; 94: e850https://doi.org/10.1097/MD.0000000000000850
- The difficult airway society 2015 guidelines and the sacred cows of routine airway management.Anaesthesia. 2016; 71: 466-467https://doi.org/10.1111/anae.13440
- Difficult tracheal intubation in obstetrics.Anaesthesia. 1984; 39: 1105-1111
- Comparison of different video laryngoscopes for emergency intubation in a standardized airway manikin with immobilized cervical spine by experienced anaesthetists. A randomized, controlled crossover trial.Resuscitation. 2012; 83: 740-745https://doi.org/10.1016/j.resuscitation.2011.11.024
- Comparisons of the GlideScope and Macintosh laryngoscope in tracheal intubation by medical students on fresh human cadavers.Tzu Chi Med J. 2009; 21: 147-150
- Importance of continuous chest compressions during cardiopulmonary resuscitation: improved outcome during a simulated single lay-rescuer scenario.Circulation. 2002; 105: 645-649
- Comparison of McGrath series 3 and Macintosh laryngoscopes for tracheal intubation in patients with normal airway by inexperienced anesthetists: a randomized study.Medicine (Baltimore). 2016; 95: e2514https://doi.org/10.1097/MD.0000000000002514
- Comparison of the TruView PCD video laryngoscope and macintosh laryngoscope for pediatric tracheal intubation by novice paramedics: a randomized crossover simulation trial.Eur J Pediatr. 2015; 174: 1325-1332https://doi.org/10.1007/s00431-015-2538-0
- Comparison of seven videolaryngoscopes with the Macintosh laryngoscope in manikins by experienced and novice personnel.Anaesthesia. 2016; 71: 556-564https://doi.org/10.1111/anae.13413
- A comparison of the Truview PCD and the GlideScope cobalt AVL video-laryngoscopes to the miller blade for successfully intubating manikins simulating normal and difficult pediatric airways.Paediatr Anaesth. 2016; 26: 613-620https://doi.org/10.1111/pan.12906
- Comparison of the Pentax, Truview, GlideScope, and the miller laryngoscope for child intubation during resuscitation.Am J Emerg Med. 2015; 33: 391-395https://doi.org/10.1016/j.ajem.2014.12.020
- Comparison of Pentax-AWS Airwayscope and Glidescope for infant tracheal intubation by anesthesiologists during cardiopulmonary arrest simulation: a randomized crossover trial.Biomed Res Int. 2015; 2015: 190163https://doi.org/10.1155/2015/190163
- Comparison of McGrath and Pentax-AWS Airwayscope for tracheal intubation by anaesthesiologists during chest compression in a manikin: a randomised crossover trial.Eur J Anaesthesiol. 2015; 32: 442-443https://doi.org/10.1097/EJA.0000000000000185
- Comparison of the Pentax Airwayscope, Glidescope video laryngoscope, and Macintosh laryngoscope during chest compression according to bed height.Medicine (Baltimore). 2016; 95: e2631https://doi.org/10.1097/MD.0000000000002631
- Simulated endotracheal intubation of a patient with cervical spine immobilization during resuscitation: a randomized comparison of the Pentax AWS, the Airtraq, and the McCoy laryngoscopes.Am J Emerg Med. 2015; 33: 1814-1817https://doi.org/10.1016/j.ajem.2015.09.005
- A randomized comparison simulating face to face endotracheal intubation of Pentax airway scope, C-MAC video laryngoscope, Glidescope video laryngoscope, and Macintosh laryngoscope.Biomed Res Int. 2015; 2015: 961782https://doi.org/10.1155/2015/961782
- Airway scope vs Macintosh laryngoscope during chest compressions on a fresh cadaver model.Am J Emerg Med. 2010; 28: 741-744https://doi.org/10.1016/j.ajem.2009.06.021
- Tracheal intubation using Macintosh and 2 video laryngoscopes with and without chest compressions.Am J Emerg Med. 2011; 29: 682-686https://doi.org/10.1016/j.ajem.2010.02.014
- Tracheal intubation using the Pentax-AWS during chest compression: a meta-analysis.Masthead. 2015; 64: 873-878
- Comparisons of the Pentax-AWS, Glidescope, and Macintosh laryngoscopes for intubation performance during mechanical chest compressions in left lateral tilt: a randomized simulation study of maternal cardiopulmonary resuscitation.Biomed Res Int. 2015; 2015: 975649https://doi.org/10.1155/2015/975649
- European resuscitation council guidelines for resuscitation 2015: section 11. The ethics of resuscitation and end-of-life decisions.Resuscitation. 2015; 95: 302-311https://doi.org/10.1016/j.resuscitation.2015.07.033
Article Info
Publication History
Published online: June 15, 2016
Accepted:
June 12,
2016
Received:
May 9,
2016
Footnotes
☆Funding: None.
☆☆Conflict of interests: The authors have no conflict of interests to disclose.
★Source of support: No sources of financial and material support to be declared.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
