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Influence of clinical experience of the Macintosh laryngoscope on performance with the Pentax-AWS Airway Scope®, a rigid video-laryngoscope, by paramedics in Japan

Journal of Anesthesia volume 29, pages 672–677 (2015)Cite this article

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.

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Fig. 1

Abbreviations

ML:

Macintosh laryngoscope

AWS:

Pentax-AWS Airway Scope®

OR:

Operating room

ID:

Internal diameter

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Acknowledgments

The authors give special thanks to Drs. Masashi Kawamoto and Hideki Fukuda at Hiroshima University Hospital, Keiichi Tada at Hiroshima City Hospital, Miwako Nakao at Hiroshima Prefectural Hospital, and Masaki Senami at Onomichi General Hospital for their assistance with data collection. This study was supported by a Science and Technology Promotion Grant 2010 of the Fire and Disaster Management Agency, Japan. A portion of our findings was presented in the report of the Emergency Medical Activities Development promoting panel (Kyukyugyoumu Koudoka Suishin Kentoukai) meeting in 2011 [21].

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Affiliations

  1. Department of Emergency and Critical Care Medicine, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi Minamiku, Hiroshima, 734-8551, Japan

    Kohei Ota, Takuma Sadamori, Tadatsugu Otani, Tomoko Tamura, Kazunobu Une, Yoshiko Kida, Junji Itai, Yasumasa Iwasaki, Nobuyuki Hirohashi & Koichi Tanigawa

  2. Emergency Medical Center, Hiroshima Prefectural Hospital, Hiroshima, Japan

    Shinji Kusunoki

  3. Department of Anesthesiology, Hiroshima General Hospital, Hiroshima, Japan

    Masakazu Nakao

Authors
  1. Kohei Ota
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  2. Takuma Sadamori
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  3. Shinji Kusunoki
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  4. Tadatsugu Otani
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  5. Tomoko Tamura
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  6. Kazunobu Une
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  7. Yoshiko Kida
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  8. Junji Itai
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  9. Yasumasa Iwasaki
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  10. Nobuyuki Hirohashi
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  11. Masakazu Nakao
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  12. Koichi Tanigawa
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Corresponding author

Correspondence to Kohei Ota.

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Ota, K., Sadamori, T., Kusunoki, S. et al. Influence of clinical experience of the Macintosh laryngoscope on performance with the Pentax-AWS Airway Scope®, a rigid video-laryngoscope, by paramedics in Japan. J Anesth 29, 672–677 (2015). https://doi.org/10.1007/s00540-014-1960-1

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  • DOI: https://doi.org/10.1007/s00540-014-1960-1

Keywords

  • Rigid video-laryngoscope
  • Endotracheal intubation
  • Paramedic