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

Abstract

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.

Progress in difficult airway management

“…One study, however, has shown that, compared with novice paramedics who had no experience with the use of a Macintosh laryngoscope, those with previous training of tracheal intubation using a Macintosh laryngoscope had a lower success rate of tracheal intubation using a videolaryngoscope [29]. This report indicates that training with a videolaryngoscope is necessary, and we need to find an appropriate training method [30].…”

Out-of-hospital endotracheal intubation experience, confidence and confidence-associated factors among Northern Japanese emergency life-saving technicians: a population-based cross-sectional study

“…Since 2011, ELSTs have also been allowed to use rigid video laryngoscopes after completion of additional training. 30 ELSTs in Japan are not permitted to perform ETI except in patients with OHCA. The indications for ETI in patients with OHCA 31 include: (1) impossibility of maintaining ventilation without ETI, such as foreign-body airway obstruction, and (2) cases in which the medical control doctor judges ETI to be required.…”

Are video laryngoscopes useful for paramedics during cardiopulmonary resuscitation?

“…Ota et al [3] performed an observational study comparing the success rate of tracheal intubation using a video laryngoscope (Pentax Airway Scope) by paramedics with and without previous training of tracheal intubation using a Macintosh laryngoscope in anesthetized patients. The success rate of tracheal intubation using the Airway Scope was high for both groups of paramedics, indicating the usefulness of the video laryngoscope.…”

“…In contrast, for the video laryngoscopes, this alignment is not required to see the glottis, and thus successful rate of tracheal intubation is generally high even in patients with restricted head and neck positions [7,8]. With these advantages in mind, Ota et al [3] have concluded that previous experience with a Macintosh laryngoscope is not necessary or required for paramedics to be trained to use the Airway Scope effectively.…”

“…At the moment, paramedics who have already been trained with the Macintosh laryngoscope are eligible to be trained with a video laryngoscope. In this issue of the Journal of Anesthesia, Ota et al [3] assessed the usefulness of this new system.…”