title: Ability of paramedics to perform endotracheal intubation during continuous chest compressions: a randomized cadaver study comparing Pentax AWS and Macintosh laryngoscopes.
abstract: OBJECTIVE
  The aim of the trial was to compare the time parameters for intubation with the use of the Macintosh (MAC) laryngoscope and Pentax AWS-S100 videolaryngoscope (AWS; Pentax Corporation, Tokyo, Japan) with and without chest compression (CC) by paramedics during simulated cardiopulmonary resuscitation in a cadaver model.
  
  
  METHODS
  This was a randomized crossover cadaver trial. Thirty-five paramedics with no experience in videolaryngoscopy participated in the study. They performed intubation in two emergency scenarios: scenario A, normal airway without CC; scenario B, normal airway with continuous CC.
  
  
  RESULTS
  The median time to first ventilation with the use of the AWS and the MAC was similar in scenario A: 25 (IQR, 22-27) seconds vs. 24 (IQR, 22.5-26) seconds (P=.072). A statistically significant difference in TTFV between AWS and MAC was noticed in scenario B (P=.011). In scenario A, the first endotracheal intubation (ETI) attempt success rate was achieved in 97.1% with AWS compared with 94.3% with MAC (P=.43). In scenario B, the success rate after the first ETI attempt with the use of the different intubation methods varied and amounted to 88.6% vs. 77.1% for AWS and MAC, respectively (P=.002).
  
  
  CONCLUSIONS
  The Pentax AWS offered a superior glottic view as compared with the MAC laryngoscope, which was associated with a higher intubation rate and a shorter intubation time during an uninterrupted CC scenario. However, in the scenario without CC, the results for AWS and MAC were comparable.
authors.affiliation: Department of Emergency Medicine, Medical University of Warsaw, Poland.
authors.forename: Zenon
authors.initials: Z
authors.lastname: Truszewski
authors.affiliation: Department of Nephrologic Nursing, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Lukasz
authors.initials: L
authors.lastname: Czyzewski
authors.affiliation: Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Smereka
authors.affiliation: Department of Forensic Medicine, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Krajewski
authors.affiliation: Department of Forensic Medicine, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Fudalej
authors.affiliation: Department of Emergency Medicine, Medical University of Warsaw, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Madziala
authors.affiliation: Department of Emergency Medicine, Medical University of Warsaw, Poland. Electronic address: lukasz.szarpak@gmail.com.
authors.forename: Lukasz
authors.initials: L
authors.lastname: Szarpak
mesh_terms: D000328:Adult; D002102:Cadaver; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D002983:Clinical Competence; D018592:Cross-Over Studies; D004634:Emergency Medical Technicians; D004867:Equipment Design; D005260:Female; D006336:Heart Massage / Q000379:methods*; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D020704:Laryngoscopes; D007828:Laryngoscopy; D008297:Male; D014741:Video Recording; D055815:Young Adult