In reply: Is Airwayscope more effective than Macintosh laryngoscope?

Abstract

To the Editor: We thank Dr. Xue and colleagues [1] for interest in our manuscript. They claim that the utility of the Pentax-AWS Airwayscope (AWS) in our simulation was not clinically validated, which is inaccurate for the following reasons. We performed our study in ‘in-hospital’ cardiac arrest simulation, which is apparently different from other ‘outof-hospital’ clinical trials that they cite. In fact, a previous clinical randomized trial conducted in the emergency ward ‘in-hospital’ setting demonstrated the superiority of the AWS [2]. There are several differences between ‘in-hospital’ and ‘out-of hospital’ CPR in clinical setting, resuscitation equipment, training of rescuers, and environmental factors. There are several aspects of the video laryngoscope that warrant improvements for outdoor usage such as in darkness or fog, and future simulations and clinical studies should address these problems [3]. As we describe in the manuscript, a simulation study utilizing a manikin has some limitations. Further clinical studies leading to meta-analysis may clarify the utility of video laryngoscopes in several situations during resuscitation.