BMC Emergency Medicine 2009 9:2
Sajid Nasim, Chrisen H Maharaj, Ihsan Butt, Muhammad A Malik John O’ Donnell, Brendan D Higgins, Brian H Harte and John G Laffey
Department of Anaesthesia, Galway University Hospitals, Ireland, Sligo General Hospital, and Department of Anaesthesia, Clinical Sciences Institute, National University of Ireland.
Background: Paramedics are frequently required to perform tracheal intubation, a potentially lifesaving manoeuvre in severely ill patients, in the prehospital setting. However, direct laryngoscopy is often more difficult in this environment, and failed tracheal intubation constitutes an important cause of morbidity. Novel indirect laryngoscopes, such as the Airtraq and Truview laryngoscopes may reduce this risk.
Methods: The authors compared the efficacy of these devices to the Macintosh laryngoscope when used by 21 Paramedics proficient in direct laryngoscopy, in a randomized, controlled, manikin study. Following brief didactic instruction with the Airtraq and Truview laryngoscopes, each participant took turns performing laryngoscopy and intubation with each device, in an easy intubation scenarioand following placement of a hard cervical collar, in a SimMan manikin.
Results: The Airtraq reduced the number of optimization manoeuvres and reduced the potential for dental trauma when compared to the Macintosh, in both the normal and simulated difficult intubation scenarios. In contrast, the Truview increased the duration of intubation attempts, and required a greater number of optimization manoeuvres, compared to both the Macintosh and Airtraq devices.
Conclusion: The Airtraq laryngoscope performed more favourably than the Macintosh andTruview devices when used by Paramedics in this manikin study. Further studies are required to
extend these findings to the clinical setting.
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