title: The rigid nasendoscope as a tool for difficult tracheal intubation: a manikin study.
abstract: We examined the use of the 30 degrees rigid nasendoscope in aiding difficult tracheal intubations. A Cormack and Lehane grade 4 difficult intubation (no view of glottis or epiglottis) was set up on a manikin. After 10 s of tuition, 40 anaesthetists attempted to pass a standard gum elastic bougie between the cords, with and without the nasendoscope, in randomised order. A bougie curved to an 'optimal curve' was also tested. Using the standard bougie 13/40 (33%) passed the bougie between the cords without the nasendoscope, compared with 31/40 (78%) when using the nasendoscope (p < 0.001). The 'optimal curve' bougie resulted in 29/40 (73%) and 39/40 (98%) success rates without and with the nasendoscope, respectively (p = 0.004). The nasendoscope is a simple and easy to use tool in grade 4 intubation, and results are improved further by the use of an 'optimal curve' bougie.
authors.affiliation: Department of Anaesthetics, University of Wales College of Medicine, Heath Park, Cardiff CF14 XN, UK. goodwin1@cf.ac.uk
authors.forename: N
authors.initials: N
authors.lastname: Goodwin
authors.forename: I P
authors.initials: IP
authors.lastname: Latto
authors.forename: I
authors.initials: I
authors.lastname: Hodzovic
authors.forename: G
authors.initials: G
authors.lastname: Williams
authors.forename: J E
authors.initials: JE
authors.lastname: Hall
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D019723:Endoscopes; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D008348:Manikins; D009296:Nasal Cavity