Correspondence  |   January 2013
In Reply
Author Affiliations & Notes
  • Karl Schebesta, M.D.
  • *Medical University of Vienna, Vienna, Austria.
Article Information
Correspondence   |   January 2013
In Reply
Anesthesiology 1 2013, Vol.118, 229-230. doi:10.1097/ALN.0b013e318276c452
Anesthesiology 1 2013, Vol.118, 229-230. doi:10.1097/ALN.0b013e318276c452
We commend Dr. Jelačićet al  . for their efforts to add further evidence to the ongoing debate of airway research based on manikins by using our radiographic technique. In particular, the evaluation of the so-called airway task trainers or low-fidelity manikins might help to develop better training options for one of the most crucial skills in anesthesia and acute care—airway management.
There is a vast multitude of airway training manikins available, including the AirSim Bronchi (Trucorp, Belfast, Northern Ireland), the Airway Management Trainer (Laerdal Medical, Stavanger, Norway), and Ambu M MegaCode Trainer W (Ambu A/S®, Ballerup, Denmark). Only some of them have been evaluated in different benchmark trials or by means of radiographic techniques because of their general availability.1–4 Obviously, we were also only able to test an unavoidably arbitrary selection of commonly used simulators.
We fully agree with Dr. Jelačićet al  . although radiographic evidence indicates that none of the evaluated manikins perfectly reflect the upper airway anatomy of actual patients (some better, some worse), other factors such as tissue elasticity and compressibility are equally important when it comes to judging how realistic a manikin can simulate an actual patient. The latter factors may be an explanation for the fact, that even though, for example, the AirSim and Airway Management Trainer significantly differ in radiographic measures, they are equal performance wise when compared with human cadavers.5 
Finally, we firmly believe that there is a significant impact of the choice of a manikin on the performance and outcome in airway management training; however, subsequent investigations are necessary to elucidate the relevance of these choices on the application and transfer of simulator training in actual patient care.
*Medical University of Vienna, Vienna, Austria.
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