Comparison of intubation performance with different airway manikins by inexperienced hands, cross-over manikin study

Abstract

Background: Endotracheal intubation (ETI) delay or failure may adversely affect patient outcomes. Therefore, airway simulation can solve this problem, but we must choose appropriate manikins for medical students.

Objectives: This study aimed to compare the application of various manikins for intubation performed by inexperienced hands and find the most effective manikins for simulation training.

Methods: This study was a prospective, randomized cross-over study. Subjects were randomly assigned to perform endotracheal intubation (ETI) using the direct laryngoscope and the video laryngoscope on three different manikins.

Results: The 32 subjects were divided into twelve internship physicians and twenty 6th year medical students. Their mean age is 24.8 ± 1.3 years, and the median number of successful intubations is 3.5 [interquartile range (IQR), 2.0 - 6.0]. The first intubation success rate in direct laryngoscope with mannikin 1 - 3 was 90.6%; Mannikin 1 illustrated the shortest time to successful ETI and showed all subjects can ETI on the first attempt. Manikin 3 with a direct laryngoscope, one internship, and two 6th year medical students failed first-time ETI. The internship group took less time than the 6th year medical student group.

Conclusion: Regarding the first intubation success rate, time to ETI, and ease of use, the manikin study demonstrated manikin 1 [Airway management trainer model (Laerdal, Norway)] is the most effective manikin for simulation training by inexperienced physicians.