title: Feasibility and speed of insertion of seven supraglottic airway devices under simulated airway conditions.
abstract: OBJECTIVE
  Endotracheal intubation (ETI) is considered the gold standard for protecting the airway. Alternative devices for airway protection have been developed that can be used by untrained personnel, by those with less experience, and for when ETI is not possible. The main goals of our study were to evaluate the success rate and speed of insertion of different supraglottic airway devices and to determine whether the devices could be properly inserted under simulated critical conditions.
  
  
  METHODS
  Fifty medical students used an airway simulation trainer (Laerdal SimMan 3G) to assess the success rate and time used to insert seven different supraglottic airway devices under simulated physiologic and pathologic conditions in two different runs.
  
  
  RESULTS
  Although all airway devices could be inserted without problems, only the Combitube and the EasyTube could be successfully inserted in simulations of trismus, limited mobility of the cervical spine, or a combination of pathologic conditions such as trismus plus limited mobility of the spine and trismus plus tongue edema. The insertion time was significantly longer with LMA Unique, Fastrach, and I-Gel devices in both the first and second runs.
  
  
  CONCLUSIONS
  The Combitube and the EasyTube were most easily inserted under simulated conditions such as trismus, limited mobility of the cervical spine, and combined pathologic conditions. Although all devices are useful for establishing an airway by nontrained medical students in standard simulations, we suggest that the Combitube and the EasyTube may offer advantages in difficult airway situations.
authors.affiliation: Department of Medicine I, Intensive Care Unit, Medical University Vienna, Vienna, Austria. oliver.robak@meduniwien.ac.at
authors.forename: Oliver
authors.initials: O
authors.lastname: Robak
authors.forename: Marco
authors.initials: M
authors.lastname: Leonardelli
authors.forename: Konstantin
authors.initials: K
authors.lastname: Zedtwitz-Liebenstein
authors.forename: Kurt
authors.initials: K
authors.lastname: Rützler
authors.forename: Ernst
authors.initials: E
authors.lastname: Schuster
authors.forename: Sonia
authors.initials: S
authors.lastname: Vaida
authors.forename: Ramez
authors.initials: R
authors.lastname: Salem
authors.forename: Michael
authors.initials: M
authors.lastname: Frass
mesh_terms: D000328:Adult; D004501:Education, Medical / Q000379:methods*; D004635:Emergency Medicine / Q000193:education*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005931:Glottis; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D008297:Male; D008348:Manikins; D008875:Middle Aged; D011482:Protective Devices; D012189:Retrospective Studies; D013337:Students, Medical; D055815:Young Adult