The use of an anaesthetic simulator to assess single-use laryngoscopy equipment.

Objective: To compare the view at simulated direct laryngoscopy obtained with a standard laryngoscope, with and without a disposable cover and a disposable laryngoscope blade.

Design: Randomized non-blinded comparison.

Setting: The high-fidelity human patient simulator at the Scottish Clinical Simulation Centre.

Participants: Thirty-two anaesthetists with between 11 months and 25 years of experience.

Interventions: A randomized comparison of ease of laryngoscopy with each laryngoscope option for simulated easy and difficult laryngoscopy.

Main Outcome Measures: The best grade achievable at laryngoscopy (Cormack and Lehane grade) for each laryngoscope, for both easy and difficult laryngoscopy.

Results: For the easy setting, 34% (P = 0.001) of anaesthetists graded laryngoscopy more difficult with the covered laryngoscope, and 22% (P = 0.008) with the disposable laryngoscope considered laryngoscopy more difficult than with the standard laryngoscope. For the difficult simulator setting, 69% (P < 0.001) found laryngoscopy more difficult with the covered laryngoscope and 69% (P < 0.001) with the disposable laryngoscope, when compared with the standard laryngoscope. There was no difference between the laryngoscopy grades for the covered and disposable laryngoscope for either easy (P = 0.21) or difficult (P = 0.87) simulation.

Conclusions: Single-use equipment, as presently recommended for tonsillectomy surgery by the UK Department of Health, makes laryngoscopy more difficult for anaesthetists.