title: Parker Flex-Tip or standard tracheal tube for percutaneous emergency airway access?
abstract: BACKGROUND
  Percutaneous emergency airway access (PEAA) can be established utilising a scalpel, bougie and cuffed tracheal tube. The study compared the Parker Flex-Tip tracheal tube with a standard tracheal tube for PEAA in cadavers. We hypothesised that a standard tracheal tube would be more likely to advance over a bougie into the trachea during a PEAA procedure than a Parker Flex-Tip tracheal tube.
  
  
  METHODS
  Three anaesthetists performed a PEAA with a scalpel, bougie and cuffed tracheal tube, 12 times each. Recorded times included: loading the tracheal tube onto the bougie and advancing the tube over the bougie to the skin, advancing the tube through the skin into the trachea and completion of the whole procedure. Subjective opinion regarding the ease of tube insertion was recorded by visual analogue scoring.
  
  
  RESULTS
  Subjective opinion, overall time and time to complete each component of the procedure were not significantly affected by the type of tube used. The mean time for three novice anaesthetists to complete PEAA on a cadaver was 37.5 (8.8) s, after 1 h of training. In two of the 12 cadavers, the cricothyroid membrane could not be palpated or located with the scalpel.
  
  
  CONCLUSIONS
  The Parker Flex-Tip tube and a standard tracheal tube perform equally well during PEAA procedures on adult cadavers.
authors.affiliation: Department of Anaesthesiology, The University of Auckland, Auckland, New Zealand. p.baker@auckland.ac.nz
authors.forename: P A
authors.initials: PA
authors.lastname: Baker
authors.forename: T M A
authors.initials: TM
authors.lastname: Fernandez
authors.forename: A E
authors.initials: AE
authors.lastname: Hamaekers
authors.forename: J M D
authors.initials: JM
authors.lastname: Thompson
mesh_terms: D000328:Adult; D058109:Airway Management / Q000295:instrumentation*; D002102:Cadaver; D004632:Emergency Medical Services; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D007821:Laryngeal Muscles / Q000502:physiology; D008297:Male; D014140:Tracheotomy / Q000295:instrumentation* / Q000379:methods