Manual laryngeal fixation facilitates tracheal intubation during chest compression: A randomized crossover manikin study

Am J Emerg Med. 2017 May;35(5):671-675. doi: 10.1016/j.ajem.2016.12.063. Epub 2016 Dec 30.

Abstract

Purpose: We compared the effectiveness of external manual laryngeal fixation (MLF) for tracheal intubation during chest compression using three laryngoscopes, the Macintosh laryngoscope (McL), McGRATH® MAC (McGRGTH), and Pentax-AWS Airwayscope® (AWS) on an adult manikin.

Methods: Sixteen novice doctors and 15 experienced anesthesiologists performed tracheal intubation during chest compression on an adult manikin using the McL, McGRATH, and AWS with or without MLF. Tracheal intubation time and intubation success rate were measured.

Results: In the AWS trial, all novice and experienced doctors successfully secured the airway with or without MLF during chest compression. In McL and McGRATH trials, MLF significantly improved the rate of successful intubation during chest compression compared to without MLF for novice doctors. While intubation time did not significantly differ with or without MLF in the AWS trial, MLF significantly shortened intubation time in McL and McGRATH trials for both novice and experienced doctors.

Conclusion: These findings suggest that MLF facilitates tracheal intubation with the McL and McGRATH during chest compression.

Keywords: Chest compression; Manual laryngeal fixation; Simulation; Tracheal intubation.

MeSH terms

  • Adult
  • Airway Management / instrumentation*
  • Cardiopulmonary Resuscitation / education
  • Cardiopulmonary Resuscitation / instrumentation*
  • Cross-Over Studies
  • Humans
  • Intubation, Intratracheal / instrumentation*
  • Japan
  • Laryngoscopes
  • Larynx*
  • Manikins*
  • Physicians
  • Pressure*
  • Random Allocation
  • Thorax*