The Airtraq Mobile® app is a new intubation solution designed to combine any smartphone to a universal adaptor fitted on any Airtraq®. High quality image resolution allows live image display and sharing, in addition to picture and movie recordings.  
This study was designed to assess the changes induced by adding the Airtraq Mobile to Airtraq SP intubations in simulated difficult airway scenario by novice users.  

This prospective, single blinded, randomized study included 106 ASA I-III adults in which difficult airway was simulated using a rigid neck collar. All novice intubators were directly assisted by an experienced Airtraq user. Patients were randomly allocated for Airtraq SP (AS) vs Airtraq Mobile (AM) intubation. 
Success and number of attempts necessary were recorded, as well as times (expressed as median seconds [25th;75th]) necessary for glottis identification, blocking of the cuff, ventilation and total procedure. Ventilation was defined as the observation of end-expiratory CO2 curve on capnography, procedure time as the time from touching the Airtraq to ventilation. 
Timing and type of assistance by the supervisor were equally analyzed. 
Subjective ease of intubation was assessed on a scale from 1 to 5 and post-operative discomfort (sore throat, hoarseness, dysphagia) evaluated 24h after intubation. 

Demographics and anatomical characteristics were identical in both groups of simulated difficult intubation. An interim analysis shows that the Airtraq Mobile device decreases the number of overall failed intubation (40% vs 60%), increases the success rate (90.6% vs 82.7%) of first attempt Airtraq assisted intubation by novice users and shortens the total time necessary for tracheal intubation (65[51;86] vs 74[51;108]). 
Timing and type of assistance by supervisor was earlier in the AM group. It was offered spontaneously respectively in n=(78.4%) vs n=(28.9%). 
Post-operative airway discomfort was less frequent in the AM group for each individual item with a three time increase of dysphagia in the AS group. 32.7% of the patients in the AS group had at least on item related to post-operative discomfort vs. 21.6% in the AM group. 

The use of the Airtraq Mobile solution to assist intubation by novice users in simulated difficult airway increases first pass success while reducing post-operative airway discomfort. Sharing the airway changes timing and type of assistance by an experienced user assisting to the procedure.  


05 / Changes induced by the Airtraq Mobile app on handling and improving intubation ease with Airtraq in simulated difficult airways by novice users