Intubation by paramedics using the ILMA or AirTraq, KingVision, and Macintosh laryngoscopes in vehicle-entrapped patients: a manikin study

Four devices were compared in a simulated scenario of a vehicle-entrapped patient: standard Macintosh laryngoscope, intubating laryngeal mask (ILMA), AirTraq optical laryngoscope, and KingVision videolaryngoscope. A group of 30 final-year paramedic students intubated a manikin placed in a sitting position under a desk simulating the roof of a car. Time of endotracheal intubation and success ratio were recorded. The baseline time of intubation was measured in a manikin lying down flat on the ground. The mean time to intubation was 13.9 +/- 6.6, 24.7 +/- 4.7, 25.2 +/- 3.7, and 23.9 +/- 4.2 s; the first attempt success ratios for devices were 29/30, 18/30, 6/30, and 18/30; and the baseline time of intubation was 14.3 +/- 6.5, 16.7 +/- 4.7, 22.9 +/- 12.6, and 18.1 +/- 5.0 s for ILMA, Macintosh laryngoscope, Airtraq, and KingVision, respectively. In emergency situations with very limited access to the patient, ILMA is the most effective device for intubation by paramedics. (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.