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J Korean Soc Emerg Med > Volume 24(4); 2013 > Article
Journal of The Korean Society of Emergency Medicine 2013;24(4): 446-452.
The Superiority of the Laryngeal Mask Airway to the Pentax(R)AirwayScope Used by an Unskilled Pre-hospital Rescuer: A Randomized, Controlled, Crossover Mannequin Study
Seong Youn Hwang, Tae Yong Shin, Young Rock Ha, Young Sik Kim, Han Ho Jeong, Jung Hyun Kim, Kyoung Yul Lee, Young Hwan Lee, Chong Kun Hong
1Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
2Department of Emergency Medicine, Bundang Jesaeng General Hospital, Bundang, Korea. schsfc@hanmail.net
3Department of Emergency Medical Technology, Masan University, Masan, Korea.
4Department of Physical Education, Kyungnam University, Changwon, Korea.
5Department of Emergency Medicine, Hallym Sacred Heart Hospital, School of Medicine, Hallym University, Changwon, Korea.
ABSTRACT
INTRODUCTION: Recent studies have highlighted the use of a video laryngoscope, a promising airway device that enables faster intubation than a Macintosh laryngoscope without the cessation of chest compressions. The aim of this study was to compare the performance of a Pentax AirwayScope (AWS) with that of a laryngeal mask airway (LMA) when utilized by unskilled personnel in a mannequin model while performing chest compressions.
METHODS:
We conducted a randomized controlled crossover trial to compare the effects of these two airway devices. A total of 36 participants performed intubation on a mannequin, with each device in both common and moderate level of difficulty airway scenarios. The time to successful ventilation, rate of ventilation success, and subjective difficulty in manipulating the devices were compared.
RESULTS:
In a scenario with airways of common difficulty, the LMA had a shorter time interval to successful ventilation than the AWS (13.6 vs. 25.2 seconds, respectively, p<0.001). In a scenario with moderately difficult airways, the LMA was also shorter than the AWS (14.5 vs. 26.9 seconds, respectively, p<0.001). For every level of difficulty for the airway, the LMA showed a higher successful ventilation rate and a lower extent of difficulty in device operation than the AWS (p<0.05).
CONCLUSION:
In the pre-hospital setting, using the LMA could enable an unskilled rescuer to establish airway patency more rapidly. LMA might also be safer and easier for operation than the AWS.
Key words: Manikins, Laryngeal masks, Endotracheal intubation
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