title: Comparison of the Glidescope and Pentax AWS laryngoscopes to the Macintosh laryngoscope for use by advanced paramedics in easy and simulated difficult intubation.
abstract: BACKGROUND
  Intubation of the trachea in the pre-hospital setting may be lifesaving in severely ill and injured patients. However, tracheal intubation is frequently difficult to perform in this challenging environment, is associated with a lower success rate, and failed tracheal intubation constitutes an important cause of morbidity. Novel indirect laryngoscopes, such as the Glidescope and the AWS laryngoscopes may reduce this risk.
  
  
  METHODS
  We compared the efficacy of these devices to the Macintosh laryngoscope when used by 25 Advanced Paramedics proficient in direct laryngoscopy, in a randomized, controlled, manikin study. Following brief didactic instruction with the Glidescope and the AWS laryngoscopes, each participant took turns performing laryngoscopy and intubation with each device, in an easy intubation scenario and following placement of a hard cervical collar, in a SimMan manikin.
  
  
  RESULTS
  Both the Glidescope and the AWS performed better than the Macintosh, and demonstrate considerable promise in this context. The AWS had the least number of dental compressions in all three scenarios, and in the cervical spine immobilization scenario it required fewer maneuvers to optimize the view of the glottis.
  
  
  CONCLUSIONS
  The Glidescope and AWS devices possess advantages over the conventional Macintosh laryngoscope when used by Advanced Paramedics in normal and simulated difficult intubation scenarios in this manikin study. Further studies are required to extend these findings to the clinical setting.
authors.affiliation: Department of Anaesthesia, Galway University Hospitals, Galway, Ireland. dr_snasim@yahoo.com
authors.forename: Sajid
authors.initials: S
authors.lastname: Nasim
authors.forename: Chrisen H
authors.initials: CH
authors.lastname: Maharaj
authors.forename: Muhammad A
authors.initials: MA
authors.lastname: Malik
authors.forename: John
authors.initials: J
authors.lastname: O' Donnell
authors.forename: Brendan D
authors.initials: BD
authors.lastname: Higgins
authors.forename: John G
authors.initials: JG
authors.lastname: Laffey
mesh_terms: D000488:Allied Health Personnel / Q000193:education*; D004867:Equipment Design; D006801:Humans; D007442:Intubation, Intratracheal; D020704:Laryngoscopes / Q000592:standards*; D008348:Manikins; D012984:Software