Randomised comparison of Enk™ and Manujet™ for emergency tracheal oxygenation with a high-fidelity full-scale...

We aimed to compare time and difficulties of emergency tracheal oxygenation with Enk™ or Manujet™ by anaesthesiologists or intensivists, in a full-scale cannot ventilate and intubate scenarios on a SimMan3G™ high-fidelity patient simulator.

After ethical committee approval and written informed consent, teams (two to three learners with at least one physician senior) participating at a difficult airway training with a massive sublingual haematoma scenario, were randomised in Enk™ (E) group (29 teams, 76 learners) and Manujet™ (M) group (31 teams, 84 learners) according to the device at disposal. Main criterion was time between taking device in hand and first insufflation delay. Data were medians [25-75%].

The handling-insufflation time was shorter with Enk™ than with Manujet™ (74 [54-87] seconds versus 95 [73-123] seconds (s), P=0.0112). The team number performing insufflation within one minute after device handling was higher in the E group (8, 27.6%) than in the M group (2, 6.4%) (P=0.0392) as well as the team number performing insufflation within 90s in the E group (22, 75.09%) than in the M group (12, 38.7%) (P=0.0047). In E group, 75% of learners reported no difficulty versus 58.8% in M group (P=0.0443). Insufflation frequency was high in both groups and higher than 12min^-1 in 51.7% of the teams.

In a simulation context, Enk™ use is faster and easier. A high insufflation rate was also in favour of Enk™ that generates lower airway pressures.