Comparison of three types of laryngoscope for tracheal intubation during rhythmic chest compressions: A manikin study

Abstract

Background If tracheal intubation can be performed during uninterrupted chest compressions, this will sustain circulation during the procedure of intubation and may lead to successful resuscitation. We compared three types of laryngoscope on a manikin as to whether they enabled tracheal intubation while the manikin's chest was rhythmically compressed. Methods A total of 35 persons who had little or no experience in intubation served as examinees. The laryngoscopes employed were a conventional Macintosh laryngoscope (MAC), a new video laryngoscope, Pentax-AWS (AWS) and an optic laryngoscope Airtraq (ATQ). During chest compression on the manikin by an assistant, the examinee attempted to perform intubation. The success rate and the time for successful intubation were measured. Results During rhythmic chest compressions, nine examinees failed in tracheal intubation with the MAC, seven failed with the ATQ, and no one failed with the AWS. The success rates with the AWS were significantly higher than those with the MAC ( P < 0.01) or ATQ ( P < 0.05). The time needed for intubation was significantly shorter with the Pentax-AWS than with the others. Conclusions These results suggest that the use of the Pentax-AWS enables tracheal intubation while the patient's chest is rhythmically compressed, and would more often lead to successful intubation, which in turn may lead to more successful resuscitation.