Department of Emergency Medicine, School of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, 108 Pyung-Dong, Jongno-Gu, Seoul 110-746, Korea.
Eur J Emerg Med. 2013 Jun;20(3):187-92. doi: 10.1097/MEJ.0b013e328354f6c4.
Experienced emergency physicians were recruited and a randomized crossover trial was conducted to compare the performance of the Pentax-Airwayscope (AWS) video-laryngoscope with the Macintosh laryngoscope (McL) for tracheal intubation during continuous chest compressions under three different scenarios: (1) normal airway, (2) limited neck mobility, and (3) tongue edema.
Thirty-six experienced emergency physicians performed intubations on a manikin in each of three scenarios. The sequences of scenarios and intubating devices were randomized. Time to complete intubation (primary end point), time to visualization of the vocal cords, the overall success rate, percentage of glottic opening, dental compression, and ease of intubation were determined.
The times (median [interquartile range]) to complete tracheal intubation were significantly shorter with the AWS than the McL in all three scenarios (11.6 [8.0-14.7] vs. 15.1 [12.8-17.9] s, 13.5 [10.5-20.9] vs. 17.0 [14.1-19.9] s, and 13.6 [11.1-20.9] vs. 15.1 [18.6-37.5] s, respectively). The overall success rates were higher with the AWS than the McL in the difficult intubation scenario (77.8 vs. 100%). The AWS was also more effective than the McL with respect to the percentage of glottic opening, dental compression, and ease of intubation in all three scenarios.
Although participants were experienced emergency physicians familiar with the McL and unfamiliar with the AWS, the AWS proved to be a better tool than the McL to perform tracheal intubation during continuous chest compressions on a manikin. The AWS should be considered as an initial intubating tool to perform tracheal intubation during continuous chest compressions rather than the McL.
招募有经验的急诊医师，并进行一项随机交叉试验，比较在三种不同情况下（1. 正常气道，2. 颈部活动受限，3. 舌水肿）连续胸部按压时，Pentax-Airwayscope（AWS）视频喉镜与 Macintosh 喉镜（McL）进行气管插管的性能。
36 名有经验的急诊医师在三种情况下的每个场景中对模拟人进行插管。场景和插管设备的顺序是随机的。确定完成插管的时间（主要终点）、声带可视化时间、总体成功率、声门开放百分比、牙齿压迫和插管难易程度。
在所有三种情况下，AWS 完成气管插管的时间（中位数[四分位距]）均显著短于 McL（11.6[8.0-14.7] 比 15.1[12.8-17.9]s，13.5[10.5-20.9] 比 17.0[14.1-19.9]s，13.6[11.1-20.9] 比 15.1[18.6-37.5]s）。在困难插管场景中，AWS 的总体成功率高于 McL（77.8% 比 100%）。AWS 在所有三种情况下的声门开放百分比、牙齿压迫和插管难易程度方面均优于 McL。
尽管参与者是熟悉 McL 但不熟悉 AWS 的有经验的急诊医师，但 AWS 被证明是在模拟人连续胸部按压时进行气管插管的比 McL 更好的工具。在连续胸部按压时进行气管插管，应将 AWS 视为初始插管工具，而不是 McL。
