A suction laryngoscope facilitates intubation for physicians with occasional emergency medical service experience--a manikin study with severe simulated airway haemorrhage.
BACKGROUND
We developed a suction laryngoscope, which enables simultaneous suction and laryngoscopy in cases of airway haemorrhage and evaluated its potential benefits in physicians with varying emergency medical service experience.


METHODS
Eighteen physicians with regular and 24 physicians with occasional emergency medical service experience intubated the trachea of a manikin with severe simulated airway haemorrhage using the suction laryngoscope and the Macintosh laryngoscope in random order.


RESULTS
In physicians with regular emergency medical service experience, there was neither a difference in time needed for intubation [median (IQR, CI 95%)]: 34 (18, 30-46) vs. 34 (22, 30-52) s; P=0.52, nor in the number of oesophageal intubations [0/18 (0%) vs. 3/18 (16.7%); P=NS] when using the suction vs. the Macintosh laryngoscope. In physicians with occasional emergency medical service experience, there was no difference in time needed for intubation [median (IQR, CI 95%)]: 42 (25, 41-57) vs. 45 (33, 41-65) s; P=0.56, but the number of oesophageal intubations was significantly lower when using the suction laryngoscope [4/24 (16.7%) vs. 12/24 (50.0%); P=0.04].


CONCLUSIONS
In a model of severe simulated airway haemorrhage, employing a suction laryngoscope significantly decreased the likelihood of oesophageal intubations in physicians with occasional emergency medical service experience.
Mitterlechner
Thomas
T
Department of Anaesthesiology and Critical Care Medicine, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria. Thomas.Mitterlechner@i-med.ac.at
Maisch
Sonja
S
Wetsch
Wolfgang A
WA
Herff
Holger
H
Paal
Peter
P
Stadlbauer
Karl H
KH
Strasak
Alexander M
AM
Lindner
Karl H
KH
Wenzel
Volker
V
D002983:Clinical Competence; D004630:Emergencies; D006470:Hemorrhage / Q000150:complications; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000706:statistics & numerical data; D020704:Laryngoscopes; D008348:Manikins; D012131:Respiratory Insufficiency / Q000150:complications / Q000628:therapy*; D013396:Suction / Q000295:instrumentation*