title: Airtraq Laryngoscope Versus the Conventional Macintosh Laryngoscope During Pediatric Intubation Performed by Nurses: A Randomized Crossover Manikin Study With Three Airway Scenarios.
abstract: OBJECTIVE
  We hypothesized that the Airtraq laryngoscope (Airtraq LLC, Bonita Springs, Fla) is beneficial for intubation of pediatric manikins while performing cardiopulmonary resuscitation (CPR). In the present study, we evaluated the effectiveness of the Macintosh (MAC) laryngoscope (HEINE Optotechnik, Munich, Germany) and Airtraq in 3 simulated CPR scenarios.
  
  
  METHODS
  A randomized crossover simulation trial was designed. Eighty-three nurses intubated the trachea of a PediaSIM CPR training manikin (FCAE HealthCare, Sarasota, Fla) using the MAC and Airtraq in a normal airway scenario, normal airway with chest compression scenario, and difficult airway with chest compression scenario. The participants were directed to perform a maximum of 3 attempts in each scenario. The success rate, time to intubation, Cormack & Lehane grade, dental compression, and the ease of intubation were measured.
  
  
  RESULTS
  All participants performed successful intubation with the Airtraq in all 3 scenarios. In all scenarios, the success rate was significantly higher and the time to intubation was significantly shorter with the Airtraq than with the MAC. Glottic visualization using the Cormack-Lehane scale was also better when using Airtraq in all scenarios.
  
  
  CONCLUSIONS
  In this manikin study, we found that the Airtraq can be used successfully for the intubation of pediatric manikins with normal and difficult airways by medical staff without previous experience in pediatric intubation. Moreover, intubation can be achieved without interrupting chest compression. The use of the Airtraq compared with the MAC led to faster time to intubation. Nevertheless, we recommend that the performance of the Airtraq and the MAC during CPR should be further evaluated in a clinical setting.
authors.affiliation: From the *Department of Emergency Medicine, Medical University of Warsaw, Warsaw; †Anesthesiology and Intensive Care Unit, Mazovian Regional Hospital, Radom; ‡Department of Nephrological Nursing, Medical University of Warsaw; and §Department of Anesthesiology, Cardinal Wyszynski National Institute of Cardiology, Warsaw, Poland.
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Szarpak
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Karczewska
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Czyżewski
authors.forename: Zenon
authors.initials: Z
authors.lastname: Truszewski
authors.forename: Andrzej
authors.initials: A
authors.lastname: Kurowski
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D002648:Child; D018592:Cross-Over Studies; D004867:Equipment Design; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000295:instrumentation*; D008297:Male; D008348:Manikins; D009726:Nurses