Potential of the AirWay Scope for tracheal intubation in a confined space

Introduction

Occasionally, rescuers are confronted with a hard situation to establish tracheal intubation compared with doctors in the anesthetic room. Especially in the confined space, the tracheal intubation must enter technical difficulties with any supporting device. This may be caused by the fact that there was no device developed specially from a standpoint in the clinical emergency use.

Objective

The AirWay Scope (AWS) is one of the newest intubation devices, manufactured using modern technology to alleviate the tracheal intubation in emergency scenes. The AWS is equipped with a full-colored CCD, a LCD monitor and a specially configured introducer guiding a tracheal tube into the glottis (Figure 1). The aim of this study is to confirm the potential of the AWS as an intubation-supporting device in emergency scenes.

Figure 1

abstract

Method

Six doctors in the emergency department were enrolled in this study. All doctors have experienced using the AWS in cases on the operation table but have no experience in special situations such as patients on the ground (POG) or no space over the head of the patient (NSH). Doctors tried intubation with the AWS and Macintosh Laryngoscope (Mac) in the simulated POG and NSH situations using a Laerdal Airway manikin. Technical training was not carried out in advance. The NSH/Mac situation was not investigated because it was theoretically impossible. The time to intubate (TTI) was recorded.

Result

All doctors successfully established intubation in each situation, POG/Mac, POG/AWS and NSH/AWS. Although the intubation of a manikin having no space over the head was thought to be difficult without prior training, all doctors successfully achieved the intubation from the foot using the AWS. The TTI (s) was 12.0 ± 1.5 in POG/Mac, 7.4 ± 1.1 in POG/AWS and 12.9 ± 1.4 in NSH/AWS. The TTI with AWS in POG situation was significantly shorter than that with Mac (P = 0.0135).

Conclusion

With its portability, easy handiness, excellent visual information and the tube-guiding function of the introducer, the AWS may have potential to alleviate the various difficulties in intubation in emergency scenes, even in a confined space.