• Nobuyasu Komasawa, Ryusuke Ueki, Motoi Itani, Shin-ichi Nishi, and Yoshiroh Kaminoh.
• Department of Anesthesiology, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya, Hyogo, 663-8501, Japan. nkomazaw@hyo-med.ac.jp
• J Anesth. 2010 Aug 1; 24 (4): 582-6.

PurposeThe 2005 American Heart Association guidelines for cardiopulmonary resuscitation emphasize that all rescuers should minimize interruption of chest compressions even for endotracheal intubation. We previously reported that the utility of the Pentax-AWS Airwayscope (AWS) was superior to that of the Macintosh laryngoscope (McL) for securing airways during chest compression in "on the bed" simulated circumstances. However, because most cardiopulmonary arrest happens "on the ground" in the real world, we compared the utility of the McL and the AWS during chest compression on the ground and on the bed.MethodsFourteen doctors training in the anesthesia department performed tracheal intubation on a manikin with the McL and the AWS in simulations "on the bed" and "on the ground".ResultsIn the McL trial, 6 participants failed on the bed, and 10 of them also failed on the ground during chest compression. In the AWS trial, all participants successfully secured the airway regardless of chest compression both on the bed and on the ground. With the AWS, intubation time was not lengthened because of chest compression either on the bed or on the ground. The AWS scored better than the McL on the visual analog scale in laryngoscopy and tube passage of the glottis both on the bed and on the ground.ConclusionWe conclude that the AWS is an effective device for endotracheal intubation during chest compression not only on the bed but also on the ground.

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