Comparison of the glidescope?, flexible fibreoptic intubating bronchoscope, iPhone modified bronchoscope, and the Macintosh laryngoscope in normal and difficult airways: a manikin study

摘要

Background Smart phone technology is becoming increasingly integrated into medical care. Our study compared an iPhone modified flexible fibreoptic bronchoscope as an intubation aid and clinical teaching tool with an unmodified bronchoscope, Glidescope? and Macintosh laryngoscope in a simulated normal and difficult airway scenario. Methods Sixty three anaesthesia providers, 21 consultant anaesthetists, 21 registrars and 21 anaesthetic nurses attempted to intubate a MegaCode Kelly? manikin, comparing a normal and difficult airway scenario for each device. Primary endpoints were time to view the vocal cords (TVC), time to successful intubation (TSI) and number of failed intubations with each device. Secondary outcomes included participant rated device usability and preference for each scenario. Advantages and disadvantages of the iPhone modified bronchoscope were also discussed. Results There was no significant difference in TVC with the iPhone modified bronchoscope compared with the Macintosh blade (P?=?1.0) or unmodified bronchoscope (P?=?0.155). TVC was significantly shorter with the Glidescope compared with the Macintosh blade (P? Conclusions The iPhone modified bronchoscope, in its current configuration, was found to be more difficult to use compared with the Glidescope? and unmodified bronchoscope; however it offered several advantages for teaching fibreoptic intubation technique when video-assisted bronchoscopy was unavailable.