Evaluation of four airway training manikins as simulators for inserting the LMA Classic^™*

Abstract

Summary Airway manikins have traditionally been used for teaching mask ventilation and tracheal intubation. There is an increasing need to use manikins for training in procedures such as insertion of the laryngeal mask airway. We have assessed four new airway training manikins (latest versions of the Airway Trainer™ (Laerdal, Norway), Airway Management Trainer™(Ambu, UK), ‘Bill 1’™(VBM, Germany) and Airsim™(Trucorp, Ireland)) as simulators for insertion of the LMA Classic™ laryngeal mask airway. Twenty volunteer anaesthetists inserted a size‐4 laryngeal mask airway five times into each of the four manikins, in random order. Each insertion was assessed using objective and subjective tests. Subjective assessment varied widely but overall assessment indicated that the Airway Management Trainer was the poorest simulator for insertion of the laryngeal mask airway. The ‘Bill 1’ and Airsim manikins performed best as simulators for insertion of the laryngeal mask airway, although realistic ventilation with ‘Bill 1’ was not possible.

Evaluation of the size 4 i‐gel™ airway in one hundred non‐paralysed patients*

“…A recent abstract reported the i-gel to be better than the LMA-Classic . It is quite possible that this was due to differences in ease of insertion of the device into a manikin as the i-gel is much easier to insert in a manikin than the cLMA [24,25]. Further work, in patients, would be welcome.…”

A quantitative review and meta‐analysis of performance of non‐standard laryngoscopes and rigid fibreoptic intubation aids

“…The use of rigid plastics, the lack of collapsible soft tissues, absence of secretions and the fact many manikins do not have anatomically correct epiglottic and laryngeal structures makes them very unlikely to be useful surrogates for evaluation of either easy or difficult intubation. We recently evaluated four modern manikin in several domains of airway management [30][31][32]. In each of the studies we observed that the manikins failed to mimic the 'softer' aspects of airway management: even when procedures (such as device insertion) were possible, they were only infrequently considered 'lifelike'.…”

Evaluation of M43B Lumbar puncture simulator‐II as a training tool for identification of the epidural space and lumbar puncture*

“…It is often used to measure respondents' attitudes by asking the extent to which they agree or disagree with a particular question or statement. The concept of lifelikeness has been used previously to compare manikins with real patients [12]. The volunteers were also asked if the simulator model was more life-like for lumbar puncture or epidural insertion; any other comments, were recorded as free text.…”