title: Utility of the Pentax-AWS Airwayscope and Macintosh laryngoscope for airway management during chest compressions in 27° left-lateral tilt: a manikin simulation study of maternal cardiopulmonary resuscitation.
abstract: OBJECTIVE
  American Heart Association (AHA) 2010 cardiopulmonary resuscitation guidelines recommend high-quality chest compressions (minimum interruption, a pace >100 compressions/min, and a depth more than 5 cm). They propose minor changes for pregnant women: manual left deviation of the uterus or a left-lateral incline of 27°-30° to alleviate pressure on the inferior vena cava. We examined the performance of the Pentax-AWS Airwayscope (AWS) and Macintosh laryngoscope (McL) for airway management during chest compressions on a 27° left-lateral tilt (27 LLT) operating table.
  
  
  METHODS
  The study included 18 novice doctors in our anesthesia department. They performed tracheal intubation on a manikin positioned on a 27 LLT operating table using the AWS or McL with or without chest compressions. We measured the intubation time and success rate for tracheal intubation.
  
  
  RESULTS
  Intubation success rate with the McL decreased with chest compressions compared to without chest compressions (12/18 vs. 18/18, P < 0.05). Intubation time with the McL was lengthened with chest compressions compared to without chest compressions (18.9 ± 4.0 s vs. 11.1 ± 1.0 s, P < 0.05). Intubation success rate was the same for the AWS with and without chest compressions (18/18 in both cases), and intubation time did not increase significantly without compressions compared to with compressions (11.6 ± 1.4 s vs. 12.6 ± 1.2 s, NS).
  
  
  CONCLUSIONS
  The AWS is an effective tool for airway management during chest compressions in 27 LLT in a manikin, suggesting that the AWS may be a useful device for airway management during maternal resuscitation.
authors.affiliation: Division of Intensive Care, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Hanako
authors.initials: H
authors.lastname: Kohama
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Komasawa
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Ueki
authors.forename: Noriyasu
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Chikara
authors.initials: C
authors.lastname: Tashiro
authors.forename: Yoshiroh
authors.initials: Y
authors.lastname: Kaminoh
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Nishi
mesh_terms: D058109:Airway Management / Q000295:instrumentation* / Q000379:methods*; D000776:Anesthesiology / Q000193:education*; D016887:Cardiopulmonary Resuscitation / Q000193:education / Q000295:instrumentation* / Q000379:methods*; D035641:Chest Wall Oscillation / Q000295:instrumentation* / Q000379:methods*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods; D020704:Laryngoscopes; D008348:Manikins; D011247:Pregnancy; D013997:Time Factors