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Comparison of endotracheal intubation performed with 3 devices by paramedics wearing chemical, biological, radiological, and nuclear personal protective equipment

      We read the article entitled “Comparison of airway intubation devices when using a biohazard suit: a feasibility study” [
      • Weaver KR
      • Barr Jr., GC
      • Long KR
      • Diaz Jr., L
      • Ratner AS
      • Reboul JP
      • et al.
      Comparison of airway intubation devices when using a biohazard suit: a feasibility study.
      ] with great interest. In the study by Weaver et al, the study group consists of 37 residents. Endotracheal intubation (ETI) is a criterion standard for airway management in many emergency situations [
      • Szarpak L
      • Karczewska K
      • Evrin T
      • Kurowski A
      • Czyzewski L
      Comparison of intubation through the McGrath MAC, GlideScope, AirTraq, and Miller laryngoscope by paramedics during child CPR: a randomized crossover manikin trial.
      ,
      • Bogdański Ł
      • Truszewski Z
      • Kurowski A
      • Czyżewski Ł
      • Zaśko P
      • Adamczyk P
      • et al.
      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.
      ]. However, in special circumstances, demanding chemical, biological, radiological, and nuclear (CBRN) personal protective equipment (PPE), with a facial filtration respirator and butyl gloves, ETI may be much more difficult than intubation during standard treatment [
      • Shin DH
      • Choi PC
      • Na JU
      • Cho JH
      • Han SK
      Utility of the Pentax-AWS in performing tracheal intubation while wearing chemical, biological, radiation and nuclear personal protective equipment: a randomised crossover trial using a manikin.
      ,
      • Castle N
      • Owen R
      • Clarke S
      • Hann M
      • Reeves D
      • Gurney I
      Does position of the patient adversely affect successful intubation whilst wearing CBRN-PPE?.
      ].
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      References

        • Weaver KR
        • Barr Jr., GC
        • Long KR
        • Diaz Jr., L
        • Ratner AS
        • Reboul JP
        • et al.
        Comparison of airway intubation devices when using a biohazard suit: a feasibility study.
        Am J Emerg Med. 2015; 33: 810-814https://doi.org/10.1016/j.ajem.2015.02.051
        • Szarpak L
        • Karczewska K
        • Evrin T
        • Kurowski A
        • Czyzewski L
        Comparison of intubation through the McGrath MAC, GlideScope, AirTraq, and Miller laryngoscope by paramedics during child CPR: a randomized crossover manikin trial.
        Am J Emerg Med. 2015; 33: 946-950https://doi.org/10.1016/j.ajem.2015.04.017
        • Bogdański Ł
        • Truszewski Z
        • Kurowski A
        • Czyżewski Ł
        • Zaśko P
        • Adamczyk P
        • et al.
        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
        • Shin DH
        • Choi PC
        • Na JU
        • Cho JH
        • Han SK
        Utility of the Pentax-AWS in performing tracheal intubation while wearing chemical, biological, radiation and nuclear personal protective equipment: a randomised crossover trial using a manikin.
        Emerg Med J. 2013; 30: 527-531https://doi.org/10.1136/emermed-2012-201463
        • Castle N
        • Owen R
        • Clarke S
        • Hann M
        • Reeves D
        • Gurney I
        Does position of the patient adversely affect successful intubation whilst wearing CBRN-PPE?.
        Resuscitation. 2010; 81: 1166-1171https://doi.org/10.1016/j.resuscitation.2010.05.009