title: Usefulness of video-laryngoscopy with the Airway Scope for intubation performance and learning: an experimental manikin controlled study.
abstract: BACKGROUND
  Different video-laryngoscopes (VDLs) for endotracheal intubation (ETI) have recently been developed. We compared the performance of the VDL Airway Scope (AWS) with the direct laryngoscopy by Macintosh (DLM) for ETI success, time and learning.
  
  
  METHODS
  We performed an experimental manikin controlled study. Twenty experienced (experts) and 40 inexperienced operators (novices) for DLM-ETI were enrolled. None of them had experience with the use of AWS-VDL. Novices were assigned to start learning with DLM or AWS, and two sub-groups of 20 novices were formed. Experts group constituted the control group. Each participant performed 10 ETI attempts with each device on the same standard manikin. The primary endpoint was the ETI success probability. Secondary endpoints were ETI time, technical validity and qualitative evaluation for each technique. We also assessed the learning order and the successive attempts effects for these parameters.
  
  
  RESULTS
  Overall, 1200 ETI attempts were performed. ETI success probability was higher with the AWS than with the DLM for all operators (98 vs. 81 %; p < 0.0001) and for experts compared to novices using devices in the same order (97 vs. 83 %; p = 0.0002). Overall ETI time was shorter with the AWS than with the DLM (13 vs. 20 s; p < 0.0001) and for experts compared to novices using devices in the same order (11 vs. 21 s; p < 0.0001). Among novices, those starting learning with AWS had higher ETI success probability (89 vs. 83 %; p = 0.03) and shorter ETI time (18 vs. 21 s; p = 0.02). Technical validity was found better with the AWS than DLM for all operators. Novices expressed global satisfaction and device preference for the AWS, whereas experts were indifferent.
  
  
  CONCLUSIONS
  AWS-VDL permits faster, easier and more reliable ETI compared to the DLM whatever the previous airway ETI experience and could be a useful device for DLM-ETI learning.
authors: Department of Medical Intensive Care, Rouen University Hospital, Rouen Cedex, France.
authors: Pierre-Louis
authors: PL
authors: Declercq
authors: Department of Clinical Research Support, Biostatistics Unit, Rouen University Hospital, Rouen Cedex, France.
authors: Michael
authors: M
authors: Bubenheim
authors: Department of Medical Intensive Care, Rouen University Hospital, Rouen Cedex, France.
authors: Stéphanie
authors: S
authors: Gelinotte
authors: Department of Medical Intensive Care, Rouen University Hospital, Rouen Cedex, France.
authors: Kévin
authors: K
authors: Guernon
authors: Department of Medical Intensive Care, Rouen University Hospital, Rouen Cedex, France.
authors: Jean-Baptiste
authors: JB
authors: Michot
authors: Department of Medical Intensive Care, Rouen University Hospital, Rouen Cedex, France.
authors: Vincent
authors: V
authors: Royon
authors: Department of Medical Intensive Care, Rouen University Hospital, Rouen Cedex, France.
authors: Dorothée
authors: D
authors: Carpentier
authors: Department of Medical Intensive Care, Rouen University Hospital, Rouen Cedex, France.|UPRES EA 3830-IRIB, Institute for Biomedical Research, Rouen University, Rouen Cedex, France.
authors: Gaëtan
authors: G
authors: Béduneau
authors: Department of Medical Intensive Care, Rouen University Hospital, Rouen Cedex, France.
authors: Fabienne
authors: F
authors: Tamion
authors: Department of Medical Intensive Care, Rouen University Hospital, Rouen Cedex, France. Christophe.Girault@chu-rouen.fr.|UPRES EA 3830-IRIB, Institute for Biomedical Research, Rouen University, Rouen Cedex, France. Christophe.Girault@chu-rouen.fr.|Service de Réanimation Médicale, Hôpital Charles Nicolle, Centre Hospitalier Universitaire-Hôpitaux de Rouen, 1, Rue de Germont, 76031, Rouen Cedex, France. Christophe.Girault@chu-rouen.fr.
authors: Christophe
authors: C
authors: Girault
keywords: Airway Scope; Intubation; Learning; Macintosh; Simulation; Video-laryngoscopy