• Pierre-Géraud Claret, Xavier Bobbia, Renaud Asencio, Emilie Sanche, Emmanuelle Gervais, Claire Roger, Mustapha Sebbane, and Jean-Emmanuel de La Coussaye.
• Department of Anesthesiology, Critical Care, Pain and Emergency Medicine, Nimes University Hospital, France.
• Eur J Emerg Med. 2016 Apr 1; 23 (2): 119-23.

ObjectiveThe rapid management of respiratory failure after exposure to a CBRN agent (chemical, biological, radiological and nuclear) is a priority leading to a decrease in mortality. We studied the performance of orotracheal intubation (OTI) with the Airtraq laryngoscope compared with the Macintosh laryngoscope by emergency physicians in protective CBRN type III personal protective equipment.Materials And MethodsIn this prospective, randomized, cross-over, single-center study, emergency room volunteer physicians with a thesis level performed, with each of the devices, six OTI tests on manikins with conventional airway. The OTI time and the OTI success rate for each device were studied. Each physician then evaluated the ease of use of each laryngoscope.ResultsThe average OTI time for Macintosh and Airtraq was 24±12 versus 37±28 s (P<0.01) and the success rate of OTI was 177/180 (98%) for Macintosh and 139/180 (78%) for Airtraq (P<0.01). Twenty-one out of 30 doctors preferred the Macintosh device to the Airtraq device for its overall ease of use (P<0.05), speed of grip (P<0.05), and ease of correct insertion of the probe (P<0.01).ConclusionThis study on manikins shows that the Macintosh laryngoscope is superior to the Airtraq laryngoscope in terms of OTI speed, efficiency, and overall ease of use. The Macintosh device is one of the alternatives in the OTI of normal airways by emergency doctors in CBRN personal protective equipment clothing.

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