Evaluation of four airway training manikins as patient simulators for the insertion of single use laryngeal mask airways.

We evaluated the performance of four manikins: Airsim(trade mark), Bill 1, Airway Management Trainer and Airway Trainer, as simulators for insertion of single-use laryngeal mask airways and the reusable LMA Classic. Sixteen volunteer anaesthetists inserted each laryngeal mask airway into each manikin twice. Insertions were scored for ease of insertion, clinical and fibreoptic position, and lung ventilation (maximum score 10). Scores < 7 were classified 'poor' and < 5 'failure'. We analysed manikin and laryngeal mask airway performance. Poor insertion rate was 15% (range 9-21%) and was lowest for the VBM manikin (p = 0.02). Insertion failure rate was 2.6% and did not differ significantly between manikins (p = 0.2). Overall manikin performance was significantly different (p < 0.0001). The VBM manikin scored best, with all other manikins equivalent. The VBM manikin performed significantly better for three individual laryngeal mask airways. Overall performance differences of laryngeal mask airways were statistically significant (p < 0.001) but individual comparisons were not. Silicone devices performed better than PVC devices (p < 0.05) Devices with and without grilles performed similarly. All manikins were adequate. The VBM manikin performed best overall and for several individual laryngeal mask airways. The methodology is useful for future evaluations of devices, both manikins and supraglottic airways. Further human clinical research is required.