Airway management with simultaneous cervical spine immobilisation: A comparison between the Macintosh laryngoscope and the Airtraq ? optical laryngoscope used by experienced paramedics – A manikin study

摘要

Abstract Background Airway management in patients with suspected or actual injury to the cervical spine remains a top priority. The aim of this study was to evaluate two different intubating devices in the hands of experienced paramedics during simulated conditions of reduced cervical spine mobility. Materials and methods Forty experienced paramedics participated in this manikin study (F?=?10, M?=?30). The time required to obtain the laryngeal inlet view as well as successful ventilation time were recorded. Cormack-Lehane laryngoscopic view and dental damage were also assessed. The two devices were used by each participant and they were randomly chosen. All paramedics participating in the study had never used the Airtraq ? device before the study but possessed intubation skills. Results The mean time required to obtain the laryngeal inlet view and the mean intubation-to-successful-ventilation time were significantly shorter when the Airtraq ? device was used, 5.5?s (±1.5) and 9.8?s (±2.7) respectively (p?=?0.003 and 0.0006). There were no failed intubation attempts in the Airtraq ? group and the use of this device had the lowest incidence of incisors damage (2 in 40 intubations, 5%). The best view of the entry to the larynx was obtained by the Airtraq ? device. Conclusion The Airtraq ? device shows advantages over the Macintosh laryngoscope in manikins and may be a good alternative in situations when reduced neck mobility is present. The use of the Airtraq ? device in manikins was associated with a shorter time for intubation and successful ventilation. It also improves the laryngoscopic view and the rate of successful intubation. Highlights ? Airway management is performed simultaneously with cervical spine immobilisation in trauma patients. ? The Airtraq ? device may be a good alternative to the Macintosh laryngoscope. ? It enables better glottic visualisation and is associated with less dental trauma. ? It reduces the duration of intubation and improves the intubation success rate.