Comparison of infant intubation through the TruView EVO2, TruView PCD, and Miller laryngoscope by paramedics during simulated infant cardiopulmonary resuscitation: A randomized crossover manikin study.
BACKGROUND
The aim of the study was to compare the efficacy of the TruView EVO2, TruView PCD, and Miller laryngoscopes for tracheal intubation during cardiopulmonary resuscitation with and without chest compressions (CCs) by paramedics in an infant manikin model.


METHODS
This was an open, prospective, randomized, simulated trial. After a brief didactic session, 78 volunteer paramedics attempted to intubate a manikin using TruView EVO2, TruView PCD, and Miller laryngoscopes during resuscitation with and without CC scenarios. Primary end point was intubation success rate and secondary was time to intubation with each device. Glottic view using a Cormack-Lehane grade in using each device was also assessed.


RESULTS
In scenario with uninterrupted CCs, the median time to intubation using the TruView EVO2, TruView PCD, and Miller varied with the times being 25.3 seconds (interquartile range [IQR], 23-30.5 seconds) vs 20.2 seconds (IQR, 18-23 seconds) vs 24.4 seconds (IQR, 21-28 seconds), respectively. The overall success rate of intubation during CC for the devices were 94.9% vs 100% vs 92.1%. During intubation without CC, median time to intubation varied and amounted to 24.9 seconds (IQR, 21-29.6 seconds) for TruView EVO2, 18.3 seconds (IQR, 16-21.3 seconds) for TruView PCD, and 19.4 seconds (IQR, 17-23.3 seconds) for Miller laryngoscope. The overall success rate of intubation without CC for all devices was 100%.


CONCLUSIONS
For infant tracheal intubation with TruView PCD, when used by paramedics, the malleable TruView PCD showed shorter intubation time and higher overall success rate in a simulated CC scenario than TruView EVO2 or Miller laryngoscopes. Further clinical studies are necessary to confirm these initial positive findings.
Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland.
Łukasz
Ł
Szarpak
Department of Anesthesiology, Cardinal Wyszynski National Institute of Cardiology, Warsaw, Poland. Electronic address: andrzejkurowski987@gmail.com.
Andrzej
A
Kurowski
Department of Anesthesiology, Cardinal Wyszynski National Institute of Cardiology, Warsaw, Poland.
Łukasz
Ł
Czyżewski
International Institute of Rescue Research and Education, Warsaw, Poland.
Marcin
M
Madziała
Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland.
Zenon
Z
Truszewski
D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation* / Q000379:methods; D018592:Cross-Over Studies; D004634:Emergency Medical Technicians; D005260:Female; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D020704:Laryngoscopes; D008297:Male; D008348:Manikins; D055815:Young Adult