title: Tracheal intubation during chest compressions performed by qualified emergency physicians unfamiliar with the Pentax-Airwayscope.
abstract: OBJECTIVE
  Experienced emergency physicians were recruited and a randomized crossover trial was conducted to compare the performance of the Pentax-Airwayscope (AWS) video-laryngoscope with the Macintosh laryngoscope (McL) for tracheal intubation during continuous chest compressions under three different scenarios: (1) normal airway, (2) limited neck mobility, and (3) tongue edema.
  
  
  METHODS
  Thirty-six experienced emergency physicians performed intubations on a manikin in each of three scenarios. The sequences of scenarios and intubating devices were randomized. Time to complete intubation (primary end point), time to visualization of the vocal cords, the overall success rate, percentage of glottic opening, dental compression, and ease of intubation were determined.
  
  
  RESULTS
  The times (median [interquartile range]) to complete tracheal intubation were significantly shorter with the AWS than the McL in all three scenarios (11.6 [8.0-14.7] vs. 15.1 [12.8-17.9] s, 13.5 [10.5-20.9] vs. 17.0 [14.1-19.9] s, and 13.6 [11.1-20.9] vs. 15.1 [18.6-37.5] s, respectively). The overall success rates were higher with the AWS than the McL in the difficult intubation scenario (77.8 vs. 100%). The AWS was also more effective than the McL with respect to the percentage of glottic opening, dental compression, and ease of intubation in all three scenarios.
  
  
  CONCLUSIONS
  Although participants were experienced emergency physicians familiar with the McL and unfamiliar with the AWS, the AWS proved to be a better tool than the McL to perform tracheal intubation during continuous chest compressions on a manikin. The AWS should be considered as an initial intubating tool to perform tracheal intubation during continuous chest compressions rather than the McL.
authors.affiliation: Department of Emergency Medicine, School of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, 108 Pyung-Dong, Jongno-Gu, Seoul 110-746, Korea.
authors.forename: Dong Hyuk
authors.initials: DH
authors.lastname: Shin
authors.forename: Sang Kuk
authors.initials: SK
authors.lastname: Han
authors.forename: Pil Cho
authors.initials: PC
authors.lastname: Choi
authors.forename: Min Seob
authors.initials: MS
authors.lastname: Sim
authors.forename: Jeong Hun
authors.initials: JH
authors.lastname: Lee
authors.forename: Sang O
authors.initials: SO
authors.lastname: Park
mesh_terms: D000328:Adult; D002983:Clinical Competence; D018592:Cross-Over Studies; D004487:Edema; D004635:Emergency Medicine; D004867:Equipment Design; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D020704:Laryngoscopes; D008297:Male; D008348:Manikins; D014059:Tongue / Q000473:pathology