Simulated Endotracheal Intubation of a Patient with Cervical Spine Immobilization During Resuscitation: a Randomized Comparison of the Pentax AWS, the Airtraq, and the McCoy Laryngoscopes

Background: Tracheal intubation during cardiopulmonary resuscitation is a high-risk procedure. The aim of this study was to compare efficacy of intubation with the Pentax AWS, Airtraq, and McCoy laryngoscopes in patients with cervical spine immobilization during resuscitation in a randomized, controlled simulation trial.

Methods: We compared times to intubation, success rate, Cormack and Lehane grading, and ease of intubation when using Pentax AWS, Airtraq, and McCoy in randomized order.

Results: The primary study end point, overall success rate, was highest when using Pentax AWS (94.0%) and was lower in Airtraq (86.6%; P = .017) and in McCoy (85.1%; P = .019). Time to first effective ventilation was achieved significantly shorter when using Pentax AWS (25.4 ± 6.7 seconds) than Airtraq (35.6 ± 5.1 seconds; P < .001) or McCoy (38.5 ± 10.3 seconds; P < .001). The quality of glottic view and ease of use were best with Pentax AWS.

Conclusions: The Pentax AWS videolaryngoscope provided a better view of the vocal cords, less insertion time, and higher success rate of the endotracheal intubation compared with the Airtraq or McCoy laryngoscopes in adults with simulated cervical spine immobilization during resuscitation.