title: Comparison of the Airtraq laryngoscope versus the conventional Macintosh laryngoscope while wearing CBRN-PPE.
abstract: OBJECTIVE
  The rapid management of respiratory failure after exposure to a CBRN agent (chemical, biological, radiological and nuclear) is a priority leading to a decrease in mortality. We studied the performance of orotracheal intubation (OTI) with the Airtraq laryngoscope compared with the Macintosh laryngoscope by emergency physicians in protective CBRN type III personal protective equipment.
  
  
  METHODS
  In this prospective, randomized, cross-over, single-center study, emergency room volunteer physicians with a thesis level performed, with each of the devices, six OTI tests on manikins with conventional airway. The OTI time and the OTI success rate for each device were studied. Each physician then evaluated the ease of use of each laryngoscope.
  
  
  RESULTS
  The average OTI time for Macintosh and Airtraq was 24±12 versus 37±28 s (P<0.01) and the success rate of OTI was 177/180 (98%) for Macintosh and 139/180 (78%) for Airtraq (P<0.01). Twenty-one out of 30 doctors preferred the Macintosh device to the Airtraq device for its overall ease of use (P<0.05), speed of grip (P<0.05), and ease of correct insertion of the probe (P<0.01).
  
  
  CONCLUSIONS
  This study on manikins shows that the Macintosh laryngoscope is superior to the Airtraq laryngoscope in terms of OTI speed, efficiency, and overall ease of use. The Macintosh device is one of the alternatives in the OTI of normal airways by emergency doctors in CBRN personal protective equipment clothing.
authors.affiliation: Department of Anesthesiology, Critical Care, Pain and Emergency Medicine, Nimes University Hospital, France.
authors.forename: Pierre-Géraud
authors.initials: PG
authors.lastname: Claret
authors.forename: Xavier
authors.initials: X
authors.lastname: Bobbia
authors.forename: Renaud
authors.initials: R
authors.lastname: Asencio
authors.forename: Emilie
authors.initials: E
authors.lastname: Sanche
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Gervais
authors.forename: Claire
authors.initials: C
authors.lastname: Roger
authors.forename: Mustapha
authors.initials: M
authors.lastname: Sebbane
authors.forename: Jean-Emmanuel
authors.initials: JE
authors.lastname: de La Coussaye
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D004636:Emergency Service, Hospital; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods; D020704:Laryngoscopes; D011481:Protective Clothing; D013997:Time Factors