Department of Anesthesiology, Buddhist Tzu Chi General Hospital, Tzu Chi University School of Medicine, Hualien 970, Taiwan, ROC.
Am J Emerg Med. 2013 Feb;31(2):330-8. doi: 10.1016/j.ajem.2012.08.026. Epub 2012 Nov 15.
Tracheal intubation is used to maintain a patent airway and can occasionally be difficult in a potentially difficult airway, especially for novice managers. In this study, we evaluated the time required, extent of the difficulty, and number of dental clicks in the tracheal intubation for novice medical students between the Macintosh (Truphatek International Ltd, Netanya, Israel) and 3 video laryngoscopes in normal and difficult simulated intubation positions on manikins on both the table and floor.
We recruited 20 medical students as novice airway managers. They used the Macintosh, Truview (Truphatek International Ltd, Netanya, Israel), Glidescope (Verathon Inc., Bothell, WA), and Airway Scope (AWS) (Pentax Corporation, Tokyo, Japan) laryngoscopes in normal and difficult simulated airways on manikins on both the table and floor. The time to intubate, modified Cormack-Lehane score, intubation difficulty score, and dental click number were estimated and compared.
All 20 medical students completed the study. The AWS required the shortest intubation time, provided the best glottic view and easiest intubation, and resulted in less dental clicks compared with the other 3 laryngoscopes; these phenomena were particularly prominent in the cervical-spine immobilization position on the floor. Although all video laryngoscopes provided better glottic views than the Macintosh laryngoscopy in terms of time to intubate, intubation difficulty score, and the number of dental clicks, the outcomes from the Macintosh laryngoscope were better than those of the Truview and Glidescope.
The AWS may have the potential for quicker, easier, and safer tracheal intubation in scenarios involving difficult airways for a novice airway manager.
气管插管用于维持通畅的气道，在潜在困难气道中偶尔会很困难，尤其是对于新手管理者。在这项研究中，我们评估了新手医学生在模拟正常和困难气道的模型上，在桌上和地板上使用 Macintosh（以色列内坦亚的 Truphatek International Ltd.）和 3 种视频喉镜进行气管插管所需的时间、困难程度和牙齿咔哒声数量。
我们招募了 20 名新手气道管理者的医学生。他们在模拟正常和困难气道的模型上，在桌上和地板上使用 Macintosh、Truview（以色列内坦亚的 Truphatek International Ltd.）、Glidescope（华盛顿州 Bothell 的 Verathon Inc.）和 Airway Scope（AWS）（日本东京的 Pentax Corporation）喉镜进行气管插管。评估并比较了插管时间、改良 Cormack-Lehane 评分、插管难度评分和牙齿咔哒声数量。
所有 20 名医学生均完成了研究。AWS 插管时间最短，提供最佳声门视图，插管最容易，与其他 3 种喉镜相比，牙齿咔哒声更少；这些现象在地板上颈椎固定位置尤为明显。虽然所有视频喉镜在插管时间、插管难度评分和牙齿咔哒声数量方面都比 Macintosh 喉镜提供了更好的声门视图，但 Macintosh 喉镜的结果优于 Truview 和 Glidescope。
对于新手气道管理者来说，在困难气道情况下，AWS 可能具有更快、更容易和更安全的气管插管潜力。
