title: Influence of clinical experience of the Macintosh laryngoscope on performance with the Pentax-AWS Airway Scope(®), a rigid video-laryngoscope, by paramedics in Japan.
abstract: OBJECTIVE
  We sought to establish the clinical utility of the Pentax-AWS Airway Scope(®) (AWS) when used by paramedics to intubate the trachea, and to evaluate whether their performance was influenced by previous clinical experience with the Macintosh laryngoscope (ML).
  
  
  METHODS
  Twenty paramedics attempted tracheal intubation using the AWS in five patients each in the operating room. We recorded the success rate, the number of intubation attempts, and the time for intubation and adverse events, and compared these based on the paramedics' previous clinical experience with the ML. Ten paramedics had no prior clinical experience of the ML (group A) and 10 had used it on more than 30 occasions (group B).
  
  
  RESULTS
  The intubation success rate was 99 % (99/100). Notably, 96 % (47/49) of intubations were achieved on the first attempt by the inexperienced paramedics in group A, compared with 64 % (32/50) by the experienced paramedics in group B (p = 0.0001). The time to intubation (mean ± SD) was significantly shorter in group A than in group B (37 ± 24 vs. 48 ± 21 s, p = 0.002). There were marked variations in the times taken to intubate, but no apparent improvement as the intubators gained experience between their first and fifth cases. No complications were encountered in either group.
  
  
  CONCLUSIONS
  We found that paramedics could achieve a high tracheal intubation success rate using the AWS independent of previous airway management experience. Better intubation performance with the AWS was observed in paramedics without clinical experience with the ML.
authors.affiliation: Department of Emergency and Critical Care Medicine, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi Minamiku, Hiroshima, 734-8551, Japan. kota@hiroshima-u.ac.jp.
authors.forename: Kohei
authors.initials: K
authors.lastname: Ota
authors.affiliation: Department of Emergency and Critical Care Medicine, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi Minamiku, Hiroshima, 734-8551, Japan.
authors.forename: Takuma
authors.initials: T
authors.lastname: Sadamori
authors.affiliation: Emergency Medical Center, Hiroshima Prefectural Hospital, Hiroshima, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Kusunoki
authors.affiliation: Department of Emergency and Critical Care Medicine, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi Minamiku, Hiroshima, 734-8551, Japan.
authors.forename: Tadatsugu
authors.initials: T
authors.lastname: Otani
authors.affiliation: Department of Emergency and Critical Care Medicine, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi Minamiku, Hiroshima, 734-8551, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Tamura
authors.affiliation: Department of Emergency and Critical Care Medicine, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi Minamiku, Hiroshima, 734-8551, Japan.
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Une
authors.affiliation: Department of Emergency and Critical Care Medicine, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi Minamiku, Hiroshima, 734-8551, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Kida
authors.affiliation: Department of Emergency and Critical Care Medicine, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi Minamiku, Hiroshima, 734-8551, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Itai
authors.affiliation: Department of Emergency and Critical Care Medicine, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi Minamiku, Hiroshima, 734-8551, Japan.
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Iwasaki
authors.affiliation: Department of Emergency and Critical Care Medicine, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi Minamiku, Hiroshima, 734-8551, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Hirohashi
authors.affiliation: Department of Anesthesiology, Hiroshima General Hospital, Hiroshima, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Nakao
authors.affiliation: Department of Emergency and Critical Care Medicine, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi Minamiku, Hiroshima, 734-8551, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Tanigawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058109:Airway Management / Q000379:methods; D000488:Allied Health Personnel; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007564:Japan; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
keywords: Endotracheal intubation; Paramedic; Rigid video-laryngoscope