Comparison of Pentax-AWS (R), Glidescope (R), and King Vision (R) for difficult-airway intubation in manikins model by paramedics

Abstract

Introduction: Prehospital tracheal intubation of a difficult airway is challenging for paramedics. Thus far, the potential role of video laryngoscopes for this purpose has not been confirmed. Therefore, this study aimed to determine the impact of different types of video laryngoscopes on the success rate and time to intubation by paramedics. Methods: This is a prospective, randomized, crossover manikin study involving 18 paramedics. Participants performed intubation on a difficult airway in a high-fidelity manikin using Pentax-AWS (R), Glidescope (R), and King Vision (R) (with two blade types). Time to intubation and success rate of intubation were determined. Participants also rated the best glottic view and reported their preferences of devices. Results: In a difficult-airway scenario, the median time to intubation with Pentax-AWS (R) was 22.9 s (interquartile range, 19.5-24.9 s), which was significantly shorter than using other devices. There were no significant differences in the time to maximal exposure of the vocal cords between four devices (p = 0.156). The time to insert the endotracheal tube with Pentax-AWS (R) and King Vision (R) with a guide-channel blade was significantly shorter than that with the other two devices (all, p < 0.05). Pentax-AWS (R) and King Vision (R) with a guide-channel blade showed higher success rates than the other two devices (p = 0.04). With regard to device preference, 14 participants preferred Pentax-AWS (R) among all devices analyzed. Conclusion: Pentax-AWS (R) could be an appropriate device for paramedics in cases of difficult airways, with high success rate.