Table 1.

Comparison of Existing Airway Management Solutions

Airway Management Approach	Device	Advantages	Limitations
Direct Laryngoscopy8–10,36–40	Macintosh (Mac) Blade	Higher success rate and lower time for novel users (vs Miller) Direct line of sight More room for ETT insertion Less trauma than Miller blade	Dental trauma Laryngeal trauma
	Miller Blade	Higher success rate with floppy glottis or anterior airways (vs Mac) Direct line of sight	More trauma than Mac blade
Indirect Laryngoscopy2–4,15–17,25,41–44	Channeled	Higher success in difficult airways Compared to DL: greater visualization and FSRs, less time, lower rate of esophageal intubation, less trauma Direct path for ETT insertion Permits multiple viewers	Reduced manipulation of ETT Variable learning curve Requires multiple devices Risk of video failure More expensive equipment Loss of depth perception
	Non-channeled	Easier manipulation and enhanced visualization over channeled	Difficulty handling ETT and scope
Bougie36,43,44		Higher FSRs than DL/IDL Can rotate 90° Small and flexible Blind intubations Confirm with tracheal ‘clicks’ Used in conjunction with IDL/DL	Risk of airway perforation tissue damage Too flexible at times= lack of shape retention Insufficient pressure by tip Difficult steerability due to flexibility
Extraglottic Devices1,36,40,45–50	LMA	Wide variety to accommodate different airway/ETT sizes Designed for blind intubation, requires less inflation for a seal; accommodates intubation with standard ETTs High injury-free success rate	Cannot be used with severe facial trauma, restricted or distorted airways, obstructions, or stiff neck/lungs Complications including dysphagia, bronchospasm, and laryngeal injury High failure in obese patients High failure with novel physicians Not compatible with airway fluids
	i-Gel	Improved seal compared to LMA High success rates in difficult airways
Surgical Airway51,52	Cricothyrotomy	Efficient for experienced physicians Minimally invasive for being an open procedure Low risk of esophageal placement	Risk of bleeding, vocal cord or airway damage, and perforation of internal membranes by blade Requires experienced physician Risk of infection and injury
	Needle	Preferred method for children Less invasive than cricothyrotomy	Risk of infection, hemorrhage, and perforation of the posterior trachea