title: Effects of a suction laryngoscope in a model with simulated severe airway hemorrhage.
abstract: In severe airway hemorrhage, simultaneous suction and laryngoscopy may render intubation difficult. We built a suction laryngoscope that consists of an adjustable stainless steel-guide tube fixed at the lingual surface of a standard Macintosh laryngoscope blade. Via this steel-guide tube, a large suction catheter can be inserted and positioned exactly to suction pharyngeal blood or vomitus, rendering simultaneous suctioning and laryngoscopy possible. In contrast to previous suction laryngoscopes, our suction catheter has a large lumen, which enables fast suctioning and exact placement by adjusting the steel-guide tube. To assess whether our suction laryngoscope could provide better intubation conditions in comparison to a standard Macintosh laryngoscope in a bleeding airway scenario, 44 medical students intubated a manikin with severe simulated airway hemorrhage using our suction laryngoscope and a standard Macintosh laryngoscope in random order. There was no significant difference in time needed for intubation when using the suction versus the Macintosh laryngoscope (mean +/- SD: 43 +/- 13 vs 52 +/- 31 s; P = 0.07), but the number of esophageal intubations was significantly lower when using the suction laryngoscope [6 of 44 (13.6%) vs 19 of 44 (43.2%); P = 0.004]. In conclusion, when compared with a standard Macintosh laryngoscope, using a suction laryngoscope did not result in more rapid intubation, but significantly decreased the likelihood of esophageal intubations.
authors.affiliation: Innsbruck Medical University, Department of Anesthesiology and Critical Care Medicine, Innsbruck, Austria. Thomas.Mitterlechner@i-med.ac.at
authors.forename: Thomas
authors.initials: T
authors.lastname: Mitterlechner
authors.forename: Nicolas
authors.initials: N
authors.lastname: Nerbl
authors.forename: Holger
authors.initials: H
authors.lastname: Herff
authors.forename: Peter
authors.initials: P
authors.lastname: Paal
authors.forename: Martin
authors.initials: M
authors.lastname: Moritz
authors.forename: Frank
authors.initials: F
authors.lastname: Kloss
authors.forename: Karl H
authors.initials: KH
authors.lastname: Lindner
authors.forename: Volker
authors.initials: V
authors.lastname: Wenzel
mesh_terms: D018592:Cross-Over Studies; D004867:Equipment Design; D006470:Hemorrhage / Q000473:pathology*; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods*; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000379:methods*; D008348:Manikins; D011446:Prospective Studies; D011897:Random Allocation; D012140:Respiratory Tract Diseases / Q000473:pathology*; D013396:Suction; D013997:Time Factors