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Background: The video-optical intubation stylet (VS) is a slim, rigid but flexible intubating device that aids physicians to intubate patients, particularly with difficult airways. Objectives: The objective of this study was to compare the performance of emergency department doctors in using different intubating devices for intubation in an airway manikin simulating different difficult airway scenarios. Methods: Thirty emergency department doctors were recruited in a pilot study. Their performance of using traditional Macintosh laryngoscope, GlideScope®, Airtraq® and C-MAC® Video Stylet were compared in three situations: normal, restricted cervical motion and limited oral aperture. The time for intubation, first attempt success rate, failure rate, dental injury and the subjective ease of different devices by the participants were compared. Result: The mean intubation time by VS in each scenario was significantly shorter compared with other devices (Normal: 19.77s vs 24.67–28.19s, p = 0.014; Cervical restriction: 20.85 vs 26.17–31.26s, p = 0.008; Limited oral aperture:19.03 vs 29.35, p = 0.001). However, there was no significant difference in failure rate or first attempt success rate. The incidence of dental injury was significantly lower with VS than other laryngoscopes (p = 0.001, p < 0.05 and p < 0.05 in normal, cervical restriction and limited oral aperture scenarios, respectively). Moreover, participants appreciated that VS was the easiest device to intubate in each scenario. (p < 0.05 in all scenarios) Conclusion: The performance of VS was comparable to or even better than the commonly used laryngoscopes in the emergency department in airway management. When adequate training is provided, VS can be a potentially good alternative for tracheal intubation in different situations. [ABSTRACT FROM AUTHOR]

Background: The suction-assisted laryngoscopy and airway decontamination (SALAD) techniques (level 1, SALAD-1 and level 2, SALAD-2) are newly proposed airway management skills to facilitate endotracheal intubation in patients with massive haematemesis. A pilot study using GlideScope® demonstrated the superior performance of SALAD-1 technique in massive haematemesis simulation. Objectives: To compare the performance of three different video laryngoscopes (the GlideScope®, the Airtraq® and the C-MAC®) in endotracheal intubation using SALAD techniques by emergency doctors in a manikin simulating massive haematemesis. Methods: Forty-eight emergency doctors were recruited. The participants' performance of endotracheal intubation using the GlideScope®, the Airtraq® and the C-MAC® with the conventional and the two SALAD techniques in a manikin simulating massive haematemesis was evaluated. The time for intubation, number of attempts, rate of failed intubation, amount of aspirated fluid and the subjective ease of different devices and techniques were compared. Results: The C-MAC® had shorter intubation time compared with GlideScope® when using conventional (mean intubation time: 28.48 vs 47.00 s, p = 0.018) and SALAD-1 technique (mean intubation time: 29.35 vs 43.25 s, p < 0.039). The intubation time of all three video laryngoscopes was similar in SALAD-2 technique. There was no significant difference in the number of attempts and failed intubation rate among different video laryngoscopes in using different techniques. Intubation with the C-MAC® resulted in the least mean amount of aspiration in all the conventional (35.63 mL), SALAD-1 (14.06 mL) and SALAD-2 (18.13 mL) techniques. However, the results were not significantly different from the GlideScope® and the Airtraq®. The C-MAC® was rated the most favourable video laryngoscope for the SALAD-1 technique (p < 0.001). There was no significant preference for different video laryngoscopes in using the SALAD-2 technique (p = 0.111). Conclusion: All the video laryngoscopes have similar intubation performance with the SALAD-1 and SALAD-2 techniques. The C-MAC® performed better than GlideScope® in terms of intubation time. The C-MAC® was the most favourable video laryngoscope for the SALAD-1 technique. [ABSTRACT FROM AUTHOR]

Background: The Suction-Assisted Laryngoscopy and Airway Decontamination techniques are newly designed emergency airway management skills to assist endotracheal intubation with the complementary use of suction catheters and video laryngoscopes in patients with severe vomiting or massive hematemesis. Objectives: To evaluate the performance of emergency department doctors in using the two Suction-Assisted Laryngoscopy and Airway Decontamination techniques (level 1 and level 2) to assist endotracheal intubation by GlideScope® in an airway manikin simulating massive hematemesis, the Nasco airway decontamination simulator. Methods: A total of 30 emergency department doctors were recruited in a pilot study. Their performance of using two levels of Suction-Assisted Laryngoscopy and Airway Decontamination techniques (Suction-Assisted Laryngoscopy and Airway Decontamination 1 and Suction-Assisted Laryngoscopy and Airway Decontamination 2) with two different suction catheters, the DuCanto suction catheter and Yankauer suction catheter, were compared with the conventional suction technique. The failed endotracheal intubation rates, time for intubation and number of attempts, amount of aspirated fluid, and the subjective ease of different methods by the participants were compared. Results: Irrespective the choice of suction catheter, endotracheal intubation in the manikin by using Suction-Assisted Laryngoscopy and Airway Decontamination 1 had the lowest failure rate which is much better than conventional suction technique (p = 0.012), smaller amount of aspiration compared with the conventional suction technique (p = 0.027), and comparable intubation time with the conventional suction technique (p = 0.850). Most participants were able to intubate the manikin successfully in the first attempt by Suction-Assisted Laryngoscopy and Airway Decontamination 1 with the DuCanto suction catheter, and they were of the opinion that such combination was the most preferred in performing endotracheal intubation. Conclusion: Suction-Assisted Laryngoscopy and Airway Decontamination 1 has the best performance in this manikin study, and Suction-Assisted Laryngoscopy and Airway Decontamination 1 with the DuCanto suction catheter was the most favorable method for endotracheal intubation in this manikin study by the participants. [ABSTRACT FROM AUTHOR]