Kohei Ota1, Takuma Sadamori2, Shinji Kusunoki3, Tadatsugu Otani2, Tomoko Tamura2, Kazunobu Une2, Yoshiko Kida2, Junji Itai2, Yasumasa Iwasaki2, Nobuyuki Hirohashi2, Masakazu Nakao4, Koichi Tanigawa2. 1. Department of Emergency and Critical Care Medicine, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi Minamiku, Hiroshima, 734-8551, Japan. kota@hiroshima-u.ac.jp. 2. Department of Emergency and Critical Care Medicine, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi Minamiku, Hiroshima, 734-8551, Japan. 3. Emergency Medical Center, Hiroshima Prefectural Hospital, Hiroshima, Japan. 4. Department of Anesthesiology, Hiroshima General Hospital, Hiroshima, Japan.
Abstract
PURPOSE: We sought to establish the clinical utility of the Pentax-AWS Airway Scope(®) (AWS) when used by paramedics to intubate the trachea, and to evaluate whether their performance was influenced by previous clinical experience with the Macintosh laryngoscope (ML). METHODS: Twenty paramedics attempted tracheal intubation using the AWS in five patients each in the operating room. We recorded the success rate, the number of intubation attempts, and the time for intubation and adverse events, and compared these based on the paramedics' previous clinical experience with the ML. Ten paramedics had no prior clinical experience of the ML (group A) and 10 had used it on more than 30 occasions (group B). RESULTS: The intubation success rate was 99 % (99/100). Notably, 96 % (47/49) of intubations were achieved on the first attempt by the inexperienced paramedics in group A, compared with 64 % (32/50) by the experienced paramedics in group B (p = 0.0001). The time to intubation (mean ± SD) was significantly shorter in group A than in group B (37 ± 24 vs. 48 ± 21 s, p = 0.002). There were marked variations in the times taken to intubate, but no apparent improvement as the intubators gained experience between their first and fifth cases. No complications were encountered in either group. CONCLUSION: We found that paramedics could achieve a high tracheal intubation success rate using the AWS independent of previous airway management experience. Better intubation performance with the AWS was observed in paramedics without clinical experience with the ML.
PURPOSE: We sought to establish the clinical utility of the Pentax-AWS Airway Scope(®) (AWS) when used by paramedics to intubate the trachea, and to evaluate whether their performance was influenced by previous clinical experience with the Macintosh laryngoscope (ML). METHODS: Twenty paramedics attempted tracheal intubation using the AWS in five patients each in the operating room. We recorded the success rate, the number of intubation attempts, and the time for intubation and adverse events, and compared these based on the paramedics' previous clinical experience with the ML. Ten paramedics had no prior clinical experience of the ML (group A) and 10 had used it on more than 30 occasions (group B). RESULTS: The intubation success rate was 99 % (99/100). Notably, 96 % (47/49) of intubations were achieved on the first attempt by the inexperienced paramedics in group A, compared with 64 % (32/50) by the experienced paramedics in group B (p = 0.0001). The time to intubation (mean ± SD) was significantly shorter in group A than in group B (37 ± 24 vs. 48 ± 21 s, p = 0.002). There were marked variations in the times taken to intubate, but no apparent improvement as the intubators gained experience between their first and fifth cases. No complications were encountered in either group. CONCLUSION: We found that paramedics could achieve a high tracheal intubation success rate using the AWS independent of previous airway management experience. Better intubation performance with the AWS was observed in paramedics without clinical experience with the ML.
Authors: Laurie J Morrison; Charles D Deakin; Peter T Morley; Clifton W Callaway; Richard E Kerber; Steven L Kronick; Eric J Lavonas; Mark S Link; Robert W Neumar; Charles W Otto; Michael Parr; Michael Shuster; Kjetil Sunde; Mary Ann Peberdy; Wanchun Tang; Terry L Vanden Hoek; Bernd W Böttiger; Saul Drajer; Swee Han Lim; Jerry P Nolan Journal: Circulation Date: 2010-10-19 Impact factor: 29.690
Authors: A Suzuki; Y Toyama; N Katsumi; T Kunisawa; R Sasaki; K Hirota; J J Henderson; H Iwasaki Journal: Anaesthesia Date: 2008-06 Impact factor: 6.955