Use of the Airtraq® device for airway management in the prehospital setting - a retrospective study

Background: Difficulties with prehospital intubations have encouraged the development of indirect laryngoscopy techniques, facilitating laryngeal visualization. Airtraq (R) is a relatively new single-use indirect laryngoscope. The Airtraq (R) has been evaluated in several prehospital mannequin intubation trials. However, prehospital clinical experience with the device is limited. Methods: A retrospective medical chart review was performed for patients who underwent prehospital endotracheal intubation in the Stockholm County between January 2008 and December 2012. Both anaesthesiologists and nurse anaesthetists performed prehospital intubations during the study period. All Airtraq (R) intubations during this period were included in the analysis. The objective was to estimate the success rate of Airtraq (R) used in a prehospital setting. Results: During the 5-year period (January 2008-December 2012), 2453 tracheal intubations were performed. Airtraq (R) was used in 28 cases (1%). The overall Airtraq (R) intubation success rate was 68%. Among patients with anticipated or unexpected difficult airway (23/28) the Airtraq (R) success rate was 61% (14/23). Among patients who underwent drug facilitated or rapid-sequence intubation protocols 4/5 (80%) were successfully intubated with Airtraq (R). Conclusion: In conclusion, this retrospective study showed a higher Airtraq (R) success rate than previous prospective prehospital trials. However, compared to other prehospital direct and indirect intubation methods the Airtraq success rate is low. Further clinical trials are necessary to evaluate the role of Airtraq (R) in the prehospital airway management.