title: Modifications to the airway management trainer intubation head for training in difficult airway recognition through a comparative study with the Airsim® intubation head.
abstract: BACKGROUND
  The goal of this study was to explain some modifications to the Airway Management Trainer intubation head (case) that transform it into a difficult airway intubation head and to compare it with the Airsim intubation head (control).
  
  
  METHODS
  Eight anesthesiologists (5 experienced and 3 residents) conducted 80 endotracheal intubations each, 10 intubations with each of the 2 airway training heads under 4 distinct clinical scenarios: normal airway, macroglossia (placing a squash ball under the tongue), cervical spine rigidity (with tape placed on the cervical spine to inhibit its extension), or both macroglossia and cervical spine rigidity. We used a Macintosh laryngoscope with a #3 blade and a 7-mm (internal diameter) endotracheal tube. The outcome variables included intubation time, ease of intubation (Likert scale), glottis visualization (Cormack-Lehane scale), and the need for maneuvers for intubation. The statistical tests used were the t test and the χ test. A P < 0.05 was considered statistically significant.
  
  
  RESULTS
  The intubation was more difficult in the case, but this difference was only statistically significant in normal airway and combining macroglossia and spinal rigidity, and the time of intubation was longer in the case than in the control. In the evaluation of the glottic view grade when we combined macroglossia and cervical rigidity, the case presented significantly more cases of Cormack-Lehane grade 3.
  
  
  CONCLUSIONS
  The present modifications proposed for the Airway Management Trainer are easy to complete to render it similar to the Airsim for training in difficult airway management.
authors.affiliation: From the Department of Anaesthesia (V.F., C.A., V.S., N.A., M.C.), Hospital Universitario de Tarragona Joan XXIII, Spain; and Nursing Department (I.D.M.), Universidad Rovira i Virgili, Tarragona, Spain.
authors.forename: Violeta
authors.initials: V
authors.lastname: Farré
authors.forename: Cristóbal
authors.initials: C
authors.lastname: Añez
authors.forename: Vicente
authors.initials: V
authors.lastname: Serrano
authors.forename: Natalia
authors.initials: N
authors.lastname: Aragonès
authors.forename: Montserrat
authors.initials: M
authors.lastname: Camps
authors.forename: Inmaculada
authors.initials: I
authors.lastname: de Molina
mesh_terms: D000776:Anesthesiology / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D007442:Intubation, Intratracheal / Q000379:methods*; D008260:Macroglossia / Q000150:complications; D008348:Manikins; D013122:Spinal Diseases / Q000150:complications; D013997:Time Factors