The Tulip GT® airway versus the Guedel airway and facemask: a randomised, controlled, cross-over clinical study comparing airway ventilation with Basic Life Support (BLS) trained airway providers in anaesthetised patients.

The tulip airway is a second generation supra-glottic airway device which has been shown to be an effective means of ventilation both in manikin and clinical studies12. The management of the emergency difficult airway may be enhanced with the use of a Tulip airway. It can be inserted where limited mouth opening may be a consideration as well as representing a possible adjunct to aid intubation in a compromised airway and as part of a failed intubation strategy.

In response to Ward and Irwin’s editorial [1], we would like to describe two randomised, controlled, cross-over trials (RCT’s) using Basic Life Support (BLS) airway providers, defined as inexperienced users (IU’s) with annually trained Guedel/Facemask skills who compared ventilation using either the Tulip GT® (TGT®) or a Guedel/Facemask (G/F) in 60 subjects, first in manikins [2] and then in humans [3] using identical protocols but within the limitations of estimation of end tidal CO2 (etCO2) in manikins.

A randomised, controlled, cross-over, human study using Basic Life Support (BLS) airway providers with annually trained Guedel airway with facemask skills compared ventilation using either the Tulip GT® airway or a Guedel airway with facemask in 60 patients after the induction of anaesthesia.

Successful resuscitation requires prompt management of the airway. Basic Life Support (BLS) trained providers, typically with only limited airway skills, are often the first responders. They must manage the patient until the arrival of personnel with advanced airway skills, and frequently look to use an oropharyngeal airway device to assist with airway management.

The editorial ‘evaluation of airway equipment: man or manikin?’ [1] states, in negative terms, that increasing numbers of publications use manikins as surrogate research subjects and concludes that ‘it is time for serious researchers to move on to study patients rather than manikins.’

The accidental omission of any authors’ competing interests and the subsequent corrigendum [1] made relating to the Difficult Airway Society ‘ADEPT’ guidance on selecting airway devices and the subsequent strategy for equipment evaluation [2] introduce several important questions.