Evaluation of airway equipment: man or manikin?

Abstract

We would like to respond to the italicised challenge in Rai and Popat’s editorial to find a published manikin study followed by a patient-based one [1]. The best example is from the Galway group that has published extensively on the Airtraq® (Prodol, Meditec S.A., Vizcaya, Spain) and other videolaryngoscopes. They followed up a manikin-based study [2] comparing the Airtraq and Macintosh laryngoscopes using experienced anaesthetists, with a randomised clinical trial in patients with normal airways [3]. They later published a study comparing the two devices in patients with simulated difficult airways by means of restriction with a cervical collar [4], and finally compared the difference in patients with predicted difficult intubation [5]. These progressive increments in difficulty must be very appealing for research and ethics committees and rather than calling for a ban on manikin studies, Rai and Popat should be challenging the research community to come up with a better manikin. There are certainly deficiencies in the current manikins; however, these could be worked upon and the deficiencies overcome if there was sufficient interest. With apologies to Ralph Waldo Emerson: “Build a better manikin and the world [anaesthetic fraternity in this case] will beat a path to your door”. No external funding and no competing interests declared. Previously posted at the Anaesthesia Correspondence website: http://www.anaesthesiacorrespondence.com.