The Airway Scope, a new video laryngoscope: its use in three patients with cervical spine problems

Liu, E.H.C.; Poon, K.H.; Ng, Bruce; Goh, Edwina; Goy, Raymond

doi:10.1093/bja/aem360

Cited by 14 publications

(8 citation statements)

References 4 publications

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“…In the prehospital and emergency environment, trauma patients often require endotracheal intubation to facilitate resuscitation. Video laryngoscopy has been shown to improve intubation in patients with an immobilized cervical spine 28 and in those with cervical spine pathology 21,29 . Increased intubation time and multiple intubation attempts have been shown to correlate with greater morbidity and mortality, and the development of a “can’t intubate–can’t ventilate” scenario 30,31 .…”

Section: Discussionmentioning

confidence: 99%

Paramedic Laryngoscopy in the Simulated Difficult Airway: Comparison of the Venner A.P. Advance and GlideScope Ranger Video Laryngoscopes

Butchart

Tjen

Garg

et al. 2011

Academic Emergency Medicine

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Objectives: This study assesses intubation times and potential trauma with two new portable video laryngoscopes, the GlideScope Ranger (GSR) and the Venner A.P. Advance (APA), in a simulated difficult prehospital airway. The GSR has a hockey stick shape and is inserted by a different (midline) technique compared with direct laryngoscopy and requires the use of a stylet. The APA has a handle similar to a direct laryngoscope, but with an angulated difficult airway blade. The APA is designed to have an intuitive insertion technique somewhat similar to that of direct laryngoscopy (lateral tongue displacement) and has a guiding mechanism that foregoes the need for a stylet.Methods: Thirty qualified paramedics received a short demonstration of each device and were asked to intubate a modified Grade III difficult laryngoscopy mannequin in a random order (closed envelope technique). Optimal view and tracheal intubation times were recorded, and potential trauma assessed by the number of additional discrete forward advances and by visual analog scale (VAS). Direct laryngoscopy was used as a comparator. The Wilcoxon rank sum test was used for intubation times, optimal view times, percentage of glottis opening (POGO) seen, and objective trauma assessment. Student's paired ttest was used for subjective trauma assessment and a Bonferroni correction was used for the primary outcome measures.Results: Participants declared a median of 60 (range 20 to 300) previous intubations. Time to achieve optimal view between APA and GSR was not different (20 seconds vs. 19 seconds; p = 0.19), but tracheal intubation was significantly faster with the APA (25 seconds vs. 46 seconds; p < 0.0001). Intubation success was ultimately 97% in both groups. Participants judged subjective trauma to be less for the APA than GSR on a VAS (1.6 cm vs. 3.3 cm; p < 0.001). More than three additional forward advances were required in 43% of GSR and 0% of APA intubations.

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Section: Discussionmentioning

confidence: 99%

Paramedic Laryngoscopy in the Simulated Difficult Airway: Comparison of the Venner A.P. Advance and GlideScope Ranger Video Laryngoscopes

Butchart

Tjen

Garg

et al. 2011

Academic Emergency Medicine

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“…To obtain a success rate of tracheal intubation with the Pentax -AWS ® , we included 14 patients who have been reported previously. 4,6,8,10,11 We recorded the patients' characteristics, preoperative view of the oropharynx (classification according to Mallampati et al 12 and Samsoon and Young 13 ), and the thyromental distance, and we predicted that tracheal intubation using a Macintosh laryngoscope would be difficult when Mallampati was 3 or 4, when the thyromental distance was less than 6 cm, or when the patient was severely or very severely obese (as 35.0 kg/m 2 or greater, according to the World Health Organization classification). We also recorded the presence of any other factors that might make tracheal intubation difficult.…”

Section: Methodsmentioning

confidence: 99%

Use of the Pentax-AWS® in 293 Patients with Difficult Airways

et al. 2009

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“…Given these features, the AWS is useful for difficult airways 2,3 and in patients with cervical spine problems. 4,5 As lifting force is not required to expose the epiglottis, 1 the AWS may be considered less invasive than the conventional Macintosh laryngoscope. To test this hypothesis, this study examined whether the AWS would reduce hemodynamic stimulation after tracheal intubation and thereby reduces bispectral index (BIS) changes compared with the Macintosh laryngoscope.…”

mentioning

confidence: 99%

Tracheal Intubation With the PENTAX-AWS (Airway Scope) Reduces Changes of Hemodynamic Responses and Bispectral Index Scores Compared With the Macintosh Laryngoscope

Nishikawa¹,

Matsuoka²,

Saito³

2009

Journal of Neurosurgical Anesthesiology

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The PENTAX-AWS, a novel video laryngoscope, allows indirect visualization of the vocal cords on a color monitor display and enables tracheal intubation without upward lifting force required to expose the glottis. This study compared hemodynamic changes, bispectral index scores, and postoperative sore throat before and after laryngoscopy between the Macintosh laryngoscope and the airway scope (AWS). Forty patients (American Society of Anesthesiologists I-II), randomly assigned to either the Macintosh group (n=20 each) or AWS group, were enrolled in this study. After induction with fentanyl (0.001 mg/kg), propofol (1.5 mg/kg), and vecuronium (0.1 mg/kg), tracheal intubation was performed. Hemodynamic parameters were compared before and after laryngoscopy. Patients were assessed for postoperative sore throat at 24 hours after extubation. No significant differences in patient characteristics were observed between groups. Significant increases in both systolic blood pressure (P<0.05 vs. baseline) and heart rate (P<0.001 vs. baseline) after laryngoscopy were seen using the Macintosh blade, whereas the AWS provided no increases in either parameter. The AWS also caused a lesser increase in bispectral index (P<0.05 vs. Macintosh group). Postoperative sore throat was observed in both groups (2 out of 20 in AWS and 6 out of 20 in Macintosh), although this difference did not reach statistically significant level (P=0.23). In conclusion, the AWS offers a reduced degree of hemodynamic stimulation compared with the Macintosh laryngoscope, suggesting that tracheal intubation with the AWS is advantageous to prevent hypertension after laryngoscopy in neurosurgical patients.

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The Airway Scope, a new video laryngoscope: its use in three patients with cervical spine problems

Cited by 14 publications

References 4 publications

Paramedic Laryngoscopy in the Simulated Difficult Airway: Comparison of the Venner A.P. Advance and GlideScope Ranger Video Laryngoscopes

Paramedic Laryngoscopy in the Simulated Difficult Airway: Comparison of the Venner A.P. Advance and GlideScope Ranger Video Laryngoscopes

Use of the Pentax-AWS® in 293 Patients with Difficult Airways

Tracheal Intubation With the PENTAX-AWS (Airway Scope) Reduces Changes of Hemodynamic Responses and Bispectral Index Scores Compared With the Macintosh Laryngoscope

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