A comparison of four techniques for the management of unanticipated difficult intubation performed on a high fidelity adult manikin

K Girgirah, PS Blair, A McIndoe

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

Thirty volunteer anaesthetists each performed endotracheal intubation on an adult manikin in an unanticipated difficult airway scenario,using four different techniques in a random order. The four techniques were: (A) blind endotracheal intubation via a classic Laryngeal Mask Airway (cLMA) (B) endotracheal intubation over an Aintree Intubation Catheter (AIC) inserted blindly via a cLMA (C) endotracheal intubation over an AIC inserted using a fibreoptic scope (FOS) via a cLMA (D) blind endotracheal intubation via an intubating LMA (iLMA). We recorded success or failure of each technique and length of time taken to successfully achieve placement of a cuffed endotracheal tube (ETT). We also recorded the preferred technique for each volunteer and collected feedback comments. Endotracheal intubation was achieved by 47% of anaesthetists using technique A, 53% using technique B, and 100% using techniques C and D. The times to successful intubation for the four techniques were significantly different. When successful, technique A was significantly faster than techniques B, C and D by 23, 64 and 42 seconds respectively. Technique B was also significantly faster than techniques C and D by 41 and 19 seconds respectively, whilst technique D was faster than technique C by an average of 22 seconds. We conclude that techniques C and D were comparable in terms of time required and were the only reliable methods of achieving intubation. Technique C (cLMA followed by AIC mounted over FOS) was the preferred option of almost two thirds of the anaesthetists who participated in the study.
Translated title of the contributionA comparison of four techniques for the management of unanticipated difficult intubation performed on a high fidelity adult manikin
Original languageEnglish
Pages (from-to)31 - 37
Number of pages7
JournalAnaesthesia Points West
Volume43(2)
Publication statusPublished - Oct 2010

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