Comparison of use of the the Airtraq with direct laryngoscopy by paramedics in the simulated airway.
BACKGROUND
Paramedics often encounter patients with difficult airways requiring emergent airway management.


OBJECTIVE
The purpose of this study was to compare intubation utilizing the Airtraq with direct laryngoscopy (DL) in the manikin model. We evaluated the number of attempts, the time to successful intubation, and the Airtraq's learning curve.


METHODS
This was a randomized, crossover study involving paramedics. Each participant was given a standardized lecture and a demonstration of the Airtraq device. After a 5-minute practice session on a Laerdal Airway Management Trainer with the Airtraq and DL, participants managed the following four scenarios on a Laerdal SimMan manikin: 1) normal airway; 2) tongue edema; 3) cervical spine immobilization; and 4) repeated normal airway. Results were analyzed using the Wilcoxon signed rank test.


RESULTS
Thirty paramedics participated in this study. For scenario 1, there were no significant differences in either the number of attempts or the time to ventilation between the devices. For scenario 2, the mean time to ventilation was significantly faster, and fewer intubation attempts were observed with the Airtraq when compared with DL. For scenario 3, there were no significant differences in number of attempts and time to ventilation. Scenario 4 demonstrated significantly less time to ventilation and fewer intubation attempts with the Airtraq. A significant decrease in time to ventilation was observed with the Airtraq when comparing scenarios 1 and 4.


CONCLUSIONS
The Airtraq was shown to be equal to or faster than DL. The Airtraq has a rapid learning curve demonstrated by a significantly decreased time to ventilation between scenarios 1 and 4.
Nowicki
Thomas A
TA
Department of Emergency Medicine, University of Connecticut/Hartford Hospital, Hartford, Connecticut 06102, USA. tnowick@harthosp.org
Suozzi
James C
JC
Dziedzic
Mark
M
Kamin
Richard
R
Donahue
Stephen
S
Robinson
Kenneth
K
D002983:Clinical Competence; D018592:Cross-Over Studies; D004496:Education, Continuing; D004634:Emergency Medical Technicians / Q000193:education*; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D007828:Laryngoscopy; D008348:Manikins; D018794:Problem-Based Learning / Q000379:methods