Endotracheal Intubation Using Three Laryngoscopes in Maternal Cardiac Arrest: a Manikin Simulation Study

Study Overview
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Brief Summary
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European Resuscitation Council (ERC) Guidelines for Resuscitation 2010 emphasize high quality chest compressions .They propose minor changes for pregnant women: manual left deviation of the uterus or a left-lateral incline of 15-30to alleviate pressure on the inferior vena cava. We will examine the performance of the Glidescope (GVL), the Pentax-AWS Airwayscope(AWS) and Macintosh laryngoscope (McL) for airway management during chest compressions on 15 and 30 degree left-lateral tilt (15 &30 LLT) custom-made hard wedges.

Detailed Description
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Materials Sim Mom manikin (Laerdal, Stavanger, Norway) Stryker ST104-747(Transport stretcher®, 760 x 2110 mm, 228 kg, Stryker Co., Kalamazoo, Michigan, US) LUCAS Chest Compression System( LUCAS Chest Compression System, Physio-Control/Jolife AB) Backboard(450 ×600 ×10 mm, 3 kg Lifeline Plastic, Sung Shim Medical Co., Bucheon, Korea)

Official Title
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Comparison of Glidescope, Pentax-AWS and Macintosh Laryngoscope for Intubation During Chest Compression in 15-30 Degree Left-Lateral Tilt: A Manikin Simulation Study of Maternal Cardiopulmonary Resuscitation

Conditions
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Cardiac Arrest

Intervention / Treatment
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* Device: 15 degree left-lateral tilt wedges
* Device: 30 degree left-lateral tilt wedges


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Experience of intubation > 50 times Postgraduates year 1,2,3,4 and Emergency physicians in emergency department Exclusion Criteria: Wrist or Low back disease

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Direct laryngoscope<br>Macintosh laryngoscope | Device: 15 degree left-lateral tilt wedges<br>* The wedges are made of aluminium<br>* Other names: Custom-made hard wedges;Device: 30 degree left-lateral tilt wedges<br>* The wedges are made of aluminium<br>* Other names: Custom-made hard wedges;|
| Experimental: Videolaryngoscope-1<br>Glidescope | Device: 15 degree left-lateral tilt wedges<br>* The wedges are made of aluminium<br>* Other names: Custom-made hard wedges;Device: 30 degree left-lateral tilt wedges<br>* The wedges are made of aluminium<br>* Other names: Custom-made hard wedges;|
| Experimental: Videolaryngoscope-2<br>Airwayscope | Device: 15 degree left-lateral tilt wedges<br>* The wedges are made of aluminium<br>* Other names: Custom-made hard wedges;Device: 30 degree left-lateral tilt wedges<br>* The wedges are made of aluminium<br>* Other names: Custom-made hard wedges;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to intubation | We will check the times from inserting blade to mouth to exposing vocal cord and from exposing vocal cord to first ambu-bagging. | 1day | 
| Success rate of intubation | Definition of failed intubation Time to intubation is longer than 90 seconds. Wrong placement of endotracheal tube (For example : Esophageal intubation etc.) | 1day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Laryngeal View during intubation | We will record the best laryngeal View during intubation. We will record according to the Cormack-Lehane Grade system. | 1day | 
| The preference for laryngoscopes | The preference for laryngoscope regardless of tilting degree of wedges The preference for laryngoscope in 15 degree left-lateral tilt situation . The preference for laryngoscope in 30 degree left-lateral tilt situation . (Participants will select only 1 of 3 laryngoscopes and the preference will be displayed as histogram) | 1day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Endotracheal intubation, Left lateral tilt wedge, Maternal Cardiopulmonary Resuscitation, Manikin Study