Endotracheal intubation using the C-MAC® video laryngoscope or the Macintosh laryngoscope: A prospective, comparative study in the ICU

Introduction

Endotracheal intubation in the ICU is a challenging procedure and is frequently associated with life-threatening complications. The aim of this study was to investigate the effect of the C-MAC^® video laryngoscope on laryngeal view and intubation success compared with direct laryngoscopy.

Methods

In a single-center, prospective, comparative before-after study in an anesthetist-lead surgical ICU of a tertiary university hospital, predictors of potentially difficult tracheal intubation, number of intubation attempts, success rate and glottic view were evaluated during a 2-year study period (first year, Macintosh laryngoscopy (ML); second year, C-MAC^®).

Results

A total of 274 critically ill patients requiring endotracheal intubation were included; 113 intubations using ML and 117 intubations using the C-MAC^® were assessed. In patients with at least one predictor for difficult intubation, the C-MAC^® resulted in more successful intubations on first attempt compared with ML (34/43, 79% vs. 21/38, 55%; P = 0.03). The visualization of the glottis with ML using Cormack and Lehane (C&L) grading was more frequently rated as difficult (20%, C&L grade 3 and 4) compared with the C-MAC^® (7%, C&L grade 3 and 4) (P < 0.0001).

Conclusion

Use of the C-MAC^® video laryngoscope improved laryngeal imaging and improved the intubating success rate on the first attempt in patients with predictors for difficult intubation in the ICU setting. Video laryngoscopy seems to be a useful tool in the ICU where potentially difficult endotracheal intubations regularly occur.     

Comparison of the King Vision Video Laryngoscope with the Macintosh Laryngoscope

Background

Endotracheal intubation is a common procedure in the emergency department, and new devices may improve intubation time, success, or view.

Objective

We compared the King Vision video laryngoscope (KVVL; King Systems, Noblesville, IN) to the Macintosh direct laryngoscope (DL) in simulated normal and difficult airways.

Methods

Using manikins and clinical-grade cadavers, difficult airway scenarios were simulated using head movement restriction or a cervical spine collar. Four scenarios were studied using the KVVL and DL: normal manikin airway, difficult manikin airway, normal cadaver airway, and difficult cadaver airway. Primary outcomes were time to intubation and rate of successful intubation. Secondary outcomes were the percent of glottic opening and Cormack-Lehane grade visualized.

Results

Thirty-two paramedics participated in the study. In the normal manikin airway scenario, time to intubation was 3.4 s (99% confidence interval [CI] 0.1–6.6) faster with the KVVL compared with DL. Time to intubation was 11.3 s (99% CI 2.4–20.2) faster with the KVVL in the difficult cadaver airway scenario. There was no difference in time to intubation in the other 2 scenarios. In the difficult cadaver airway, 10 of 32 participants failed to successfully intubate the trachea using DL, whereas all KVVL intubations were successful. All scenarios found a lower Cormack-Lehane grade and higher percentage of glottic opening with the KVVL compared to DL.

Conclusion

The KVVL was slightly faster than Macintosh DL in two of four studied airway scenarios, and had a higher success rate in the difficult cadaver airway scenario. Further study is required in the clinical setting.     

Video laryngoscopy improves intubation success and reduces esophageal intubations compared to direct laryngoscopy in the medical intensive care unit

Introduction

Tracheal intubation in the Intensive Care Unit (ICU) can be challenging as patients often have anatomic and physiologic characteristics that make intubation particularly difficult. Video laryngoscopy (VL) has been shown to improve first attempt success compared to direct laryngoscopy (DL) in many clinical settings and may be an option for ICU intubations.

Methods

All intubations performed in this academic medical ICU during a 13-month period were entered into a prospectively collected quality control database. After each intubation, the operator completed a standardized form evaluating multiple aspects of the intubation including: patient demographics, difficult airway characteristics (DACs), method and device(s) used, medications used, outcomes and complications of each attempt. Primary outcome was first attempt success. Secondary outcomes were grade of laryngoscopic view, ultimate success, esophageal intubations, and desaturation. Multivariate logistic regression was performed for first attempt and ultimate success.

Results

Over the 13-month study period (January 2012-February 2013), a total of 234 patients were intubated using VL and 56 patients were intubated with DL. First attempt success for VL was 184/234 (78.6%; 95% CI 72.8 to 83.7) while DL was 34/56 patients (60.7%; 95% CI 46.8 to 73.5). Ultimate success for VL was 230/234 (98.3%; 95% CI 95.1 to 99.3) while DL was 52/56 patients (91.2%; 95% CI 81.3 to 97.2). In the multivariate regression model, VL was predictive of first attempt success with an odds ratio of 7.67 (95% CI 3.18 to 18.45). VL was predictive of ultimate success with an odds ratio of 15.77 (95% CI 1.92 to 129). Cormack-Lehane I or II view occurred 199/234 times (85.8%; 95% CI 79.5 to 89.1) and a median POGO (Percentage of Glottic Opening) of 82% (IQR 60 to 100) with VL, while Cormack-Lehane I or II view occurred 34/56 times (61.8%; 95% CI 45.7 to 71.9) and a median POGO of 45% (IQR 0 to 78%) with DL. VL reduced the esophageal intubation rate from 12.5% with DL to 1.3% (P = 0.001) but there was no difference in desaturation rates.

Conclusions

In the medical ICU, video laryngoscopy resulted in higher first attempt and ultimate intubation success rates and improved grade of laryngoscopic view while reducing the esophageal intubation rate compared to direct laryngoscopy.     

Comparison of optic laryngoscope Airtraq(®) and Miller laryngoscope for tracheal intubation during infant cardiopulmonary resuscitation

Background

Recent resuscitation guidelines for infant cardiopulmonary resuscitation (CPR) emphasize that all rescuers should minimize interruption of chest compressions, even for endotracheal intubation. We compared the utility of the Miller laryngoscope (Mil) with Airtraq (ATQ) during chest compression in an infant manikin.

Methods

Twenty staff doctors in intensive care and emergency medicine performed tracheal intubation on an infant manikin with Mil and ATQ with or without chest compression.

Results

In Mil trials, no participants failed without chest compression, but 6 of them failed during chest compression (P < 0.05). In ATQ trials, all participants successfully secured the airway regardless of chest compression. Intubation time was significantly lengthened due to chest compression in Mil trials, but not in ATQ trials. The visual analog scale (VAS) for laryngoscope image did not significantly change due to chest compression for ATQ or Mil trials. In contrast, chest compression worsened VAS scores for tube passage through the glottis in Mil trials, but not in ATQ trials.

Conclusion

We conclude that ATQ performed better than Mil for endotracheal intubation during chest compression in infant simulations managed by expert doctors.     

Airtraq视频喉镜联合纤维支气管镜在困难气道插管中的效果评价

目的分析评价Airtraq视频喉镜联合纤维支气管镜(FOB)在处理困难气道中的临床效果。方法选择全身麻醉手术患者,术前经麻醉医师行Mallampati评估分级为Ⅲ或Ⅳ级,美国麻醉医师协会(ASA)分级Ⅰ或Ⅱ级,常规麻醉诱导后,先用普通喉镜行Cormack-Lehane评级,Ⅰ或Ⅱ级患者直接插管,将Ⅲ或Ⅳ级患者随机分为Airtraq视频喉镜联合FOB(A组)30例与Airtraq视频喉镜(B组)30例,然后实施经口气管插管,观察并记录两组患者插管次数、插管总时间、血流动力学变化及咽喉部损伤、咽喉痛情况。结果 A组患者插管时间和插管次数明显小于B组患者,差异均有统计学意义(P 0.05);插管前后,两组收缩压(SBP)、心率(HR)和血氧饱和度(SpO_2)比较,差异均无统计学意义(P0.05)。结论全身麻醉时应用Airtraq视频喉镜联合FOB,Cormack-Lehane评级Ⅲ级以上患者经口气管插管,具有全程可视、成功率高、插管时间短和减少气道及咽部损伤的优势。     

Comparison of Macintosh and Intubrite laryngoscopes for intubation performed by novice physicians in a difficult airway scenario

Introduction

In the difficult airway, the intubation skills are critically important. In selected cases, particularly in airway edema, laryngeal or tongue edema, endotracheal intubation can turn out very difficult, and repeated attempts may even worsen the airway edema, causing trauma and bleeding, and finally leading to complete airway obstruction and inability to ventilate the patient.

Utility of the Pentax-AWS without interruption of chest compression: Comparison of the Macintosh laryngoscope with the Pentax-AWS in manikin model

Background

Emergency airway management in suboptimal conditions can result in difficulties in tracheal intubation. The video laryngoscope (Pentax-AWS^®) has potential advantages during difficult tracheal intubations. According to the 2005 guidelines for cardiopulmonary resuscitation (CPR), all rescuers should minimize interruption of chest compressions. Our hypothesis is that tracheal intubation using the Pentax-AWS^® is possible without interruption of chest compressions. We tested this using tracheal intubation performed by less experienced medical personnel in a manikin model.

Methods

Thirty-two less experienced (<10 tracheal intubations) medical interns performed intubation using the Pentax-AWS^® and the Macintosh laryngoscope in an ALS simulator (Laerdal, Stavanger, Norway) in each of three scenarios. The three scenarios were: (1) normal airway without chest compression, (2) normal airway with continuous chest compression, and (3) difficult airway with continuous chest compression. The success rate, time required to complete tracheal intubation and to visualize vocal cords, POGO (percentage of glottic opening) score, dental compression and the ease of intubation were recorded.

Results

All participants performed successful intubation with the Pentax-AWS^® in the three scenarios. In the two continuous chest compression scenarios (scenarios 2 and 3), the success rate was significantly higher with the Pentax-AWS^® than with the Macintosh laryngoscope.

Conclusions

The Pentax-AWS^® was an effective tool for endotracheal intubation during chest compression performed by less experienced medical personnel in a manikin model simulating cardiac arrest, both under conditions of normal and difficult airways.     

Truview EVO2喉镜用于模拟颈椎固定致困难气道的研究

目的:评估麻醉住院医师在人体模型模拟颈椎固定致困难气道上使用Truview EVO2喉镜的效果.方法:20位未有在人体使用Truview EVO2喉镜经验的麻醉科住院医师,在高级麻醉医生讲解该喉镜使用方法并指导其在人体模型上以正常插管体位下成功完成3次插管,然后分别使用Macintosh喉镜和Truview EVO2喉镜在模型模拟颈椎后仰不能的情况下进行插管,记录喉镜暴露时间、插管时间、失败次数、喉镜暴露分级(C-L分级),并由受试者评定插管困难程度和对两种喉镜的喜好.结果:与Macintosh喉镜相比,Truview EVO2喉镜能显著改善颈椎后仰不能情况下的C-L分级(P＜0.05),但并不缩短插管所耗时间和减少失败次数.受试者评价Truview EVO2插管困难程度与Macintosh喉镜无显著差异.结论:与传统插管方法相比,Truview EVO2用于人体模型模拟颈椎固定所致困难气道时可显著改善声门暴露,但对于使用经验不足的操作者并不能缩短插管时间.     

Comparison of the Pentax AWS videolaryngoscope with the Macintosh laryngoscope in simulated difficult airway intubations by emergency physicians

Objectives

The aim of this study was to evaluate the Pentax AWS videolaryngoscope (PAV) in intubation of simulated difficult airways by emergency medical staff.

Methods

Emergency medical staff and students attempted to intubate a manikin using 3 difficult airways settings with both the PAV and a Macintosh (MAC) laryngoscope in a randomized order. The success of tracheal intubation, time required, number of attempts, airway adjunct use, grade of view obtained, and participant comments were recorded.

Results

Significantly higher success rates of intubation occurred with the PAV compared with the MAC, irrespective of the level of training or number of previous intubations. With the highest difficulty setting, success occurred in 76.4% with the PAV versus 8.8% with the MAC. The PAV also significantly improved the Cormack and Lehane grading and reduced airway adjunct use, number of intubation attempts, and damage during intubation.

Conclusions

The PAV may be a useful adjunct in difficult intubations by emergency medical staff.     

Airtraq视频喉镜与Macintosh直接喉镜经口气管插管时的血流动力学比较

背景：常规使用Macintosh直接喉镜气管插管可引起强烈的血流动力学反应,从原理上讲,Airtraq视频喉镜对咽喉刺激小,但两者对血流动力学影响的比较研究尚未见报道。 目的：比较Airtraq视频喉镜和Macintosh直接喉镜经口气管插管时的血流动力学反应。 设计、时间及地点：随机对照观察,于2008-10/2009-04在大连市第二人民医院麻醉科完成。 对象：40例拟经口气管插管全身麻醉下择期手术患者,按随机数字表法分为Airtraq视频喉镜组和Macintosh直接喉镜组,每组20例。 方法：麻醉诱导后分别使用Airtraq视频喉镜和Macintosh直接喉镜显露声门行气管插管。Airtraq视频喉镜组选择普通型的Airtraq视频喉镜,置入内径为8.0的气管导管。Macintosh直接喉镜组选用3号镜片,使用内径为8.0的气管导管。 主要观察指标：声门显露时间、导管置入时间、麻醉诱导前、气管插管前、气管插管后即刻、气管插管后1,2,3min时的收缩压、舒张压、心率,计算各观察时点的二重指数。 结果：Airtraq视频喉镜组声门显露时间长于Macintosh直接喉镜组（P〈0.01）;导管置入时间Airtraq视频喉镜组短于Macintosh直接喉镜组（P〈0.01）。与麻醉诱导前相比,两组气管插管前收缩压、舒张压、二重指数均明显下降（P〈0.05）,心率变化不明显（P〉0.05）。与气管插管前相比,Airtraq视频喉镜组插管时及插管后各时点血流动力学指标无明显变化（P〉0.05）,Macintosh直接喉镜组气管插管后2min时心率、二重指数,气管插管后即刻、气管插管后1min收缩压、舒张压、心率和二重指数显著升高（P〈0.05）。气管插管后即刻、气管插管后1,2minMacintosh直接喉镜组心率、二重指数显著高于Airtraq视频喉镜组（P〈0.05）。 结论：与Macintosh直接喉镜相比,应用Airtraq视频喉镜行经口气管插管患者血流动力学反应较轻。     

Comparison of Xenon with LED illuminant in difficult and inhalation injury airway scenario: A randomized crossover manikin study

Purpose

The purpose of this study was to compare the effectiveness of a Xenon halogen with a light-emitting diode (LED) laryngoscope light handle in a difficult airway scenario, as well as in an inhalation injury airway scenario that combines a difficult airway and a limited view.

A suction laryngoscope facilitates intubation for physicians with occasional emergency medical service experience—A manikin study with severe simulated airway haemorrhage

Introduction

We developed a suction laryngoscope, which enables simultaneous suction and laryngoscopy in cases of airway haemorrhage and evaluated its potential benefits in physicians with varying emergency medical service experience.

Methods

Eighteen physicians with regular and 24 physicians with occasional emergency medical service experience intubated the trachea of a manikin with severe simulated airway haemorrhage using the suction laryngoscope and the Macintosh laryngoscope in random order.

Results

In physicians with regular emergency medical service experience, there was neither a difference in time needed for intubation [median (IQR, CI 95%)]: 34 (18, 30–46) vs. 34 (22, 30–52) s; P = 0.52, nor in the number of oesophageal intubations [0/18 (0%) vs. 3/18 (16.7%); P = NS] when using the suction vs. the Macintosh laryngoscope. In physicians with occasional emergency medical service experience, there was no difference in time needed for intubation [median (IQR, CI 95%)]: 42 (25, 41–57) vs. 45 (33, 41–65) s; P = 0.56, but the number of oesophageal intubations was significantly lower when using the suction laryngoscope [4/24 (16.7%) vs. 12/24 (50.0%); P = 0.04].

Conclusions

In a model of severe simulated airway haemorrhage, employing a suction laryngoscope significantly decreased the likelihood of oesophageal intubations in physicians with occasional emergency medical service experience.     

Effect of cardiopulmonary resuscitation on intubation using a Macintosh laryngoscope, the AirWay Scope, and the gum elastic bougie: A manikin study

Background

Physicians could encounter difficult intubation during cardiopulmonary resuscitation (CPR) in trauma patients due to the patient's movement from continuous chest compression and to cervical stabilisation. Therefore, first, we evaluated the impact of chest compression with or without cervical stabilisation on intubation with a Macintosh laryngoscope. Next, we compared difficulty in intubation among the Macintosh laryngoscope, AirWay Scope (AWS), and gum elastic bougie (GEB) with the Macintosh laryngoscope in three simulated CPR scenarios in a randomised, controlled, cross-over study design.

Methods

Twenty-three anaesthetists intubated the trachea of a manikin (ALS Skill Master, Laerdal Medical Japan, Tokyo, Japan) using the Macintosh laryngoscope, AWS, and GEB in the control scenario, chest compression scenario, and chest compression with cervical stabilisation scenario. Difficulty in intubation was rated on a 5-point scale and the intubation time was measured.

Results

Continuous chest compression increased difficulty in intubation with the Macintosh laryngoscope, compared with the control scenario. Concurrent application of cervical stabilisation further increased the difficulty, compared with application of chest compression alone. Of the three devices compared, the AWS facilitated the easiest intubation, and the GEB facilitated the second-easiest intubation in all scenarios, though the intubation time was slightly longer with the GEB than with other devices.

Conclusion

CPR employing continuous chest compression with or without cervical stabilisation caused difficult intubation with the Macintosh laryngoscope. The AWS and GEB facilitated the easiest and second-easiest intubation, respectively, even during CPR employing continuous chest compression with or without cervical stabilisation in a manikin.     

Airtraq可视喉镜在急诊手术清醒气管插管术中的临床应用

目的探讨Airtraq可视喉镜在急诊手术患者处于清醒状态下进行气管插管的临床效果和安全性。方法选取2011年7月至2013年12月因急诊手术需要接受气管插管的患者62例作为研究对象。按随机数表将患者随机分为普通喉镜插管组和Airtraq可视喉镜插管组,对两组患者的插管所需时间、一次性插管成功率以及插管时的血流动力学变化进行对比与分析。结果 Airtraq可视喉镜插管组的平均插管时间为(19.5±6.2)s,与普通喉镜插管组(28.7±7.3)s相比明显缩短,前者的一次性插管成功率(100%)明显高于后者(64.52%),差异具有统计学意义(P0.05);且前者的血流动力学变化幅度小于后者,差异具有统计学意义(P0.05)。结论 Airtraq可视喉镜在急诊患者处于清醒状态下的气管插管技术操作简单,图像清晰,成功率高,并发症少,值得临床推广应用。     

Assessment of candidemia-attributable mortality in critically ill patients using propensity score matching analysis

Introduction

Endotracheal intubation in the ICU is a challenging procedure and is frequently associated with life-threatening complications. The aim of this study was to investigate the effect of the C-MAC^? video laryngoscope on laryngeal view and intubation success compared with direct laryngoscopy.

Methods

In a single-center, prospective, comparative before-after study in an anesthetist-lead surgical ICU of a tertiary university hospital, predictors of potentially difficult tracheal intubation, number of intubation attempts, success rate and glottic view were evaluated during a 2-year study period (first year, Macintosh laryngoscopy (ML); second year, C-MAC^?).

Results

A total of 274 critically ill patients requiring endotracheal intubation were included; 113 intubations using ML and 117 intubations using the C-MAC^? were assessed. In patients with at least one predictor for difficult intubation, the C-MAC^? resulted in more successful intubations on first attempt compared with ML (34/43, 79% vs. 21/38, 55%; P = 0.03). The visualization of the glottis with ML using Cormack and Lehane (C&L) grading was more frequently rated as difficult (20%, C&L grade 3 and 4) compared with the C-MAC^? (7%, C&L grade 3 and 4) (P < 0.0001).

Conclusion

Use of the C-MAC^? video laryngoscope improved laryngeal imaging and improved the intubating success rate on the first attempt in patients with predictors for difficult intubation in the ICU setting. Video laryngoscopy seems to be a useful tool in the ICU where potentially difficult endotracheal intubations regularly occur.     

Comparison of three types of laryngoscope for tracheal intubation during rhythmic chest compressions: A manikin study

Background

If tracheal intubation can be performed during uninterrupted chest compressions, this will sustain circulation during the procedure of intubation and may lead to successful resuscitation. We compared three types of laryngoscope on a manikin as to whether they enabled tracheal intubation while the manikin's chest was rhythmically compressed.

Methods

A total of 35 persons who had little or no experience in intubation served as examinees. The laryngoscopes employed were a conventional Macintosh laryngoscope (MAC), a new video laryngoscope, Pentax-AWS (AWS) and an optic laryngoscope Airtraq (ATQ). During chest compression on the manikin by an assistant, the examinee attempted to perform intubation. The success rate and the time for successful intubation were measured.

Results

During rhythmic chest compressions, nine examinees failed in tracheal intubation with the MAC, seven failed with the ATQ, and no one failed with the AWS. The success rates with the AWS were significantly higher than those with the MAC (P < 0.01) or ATQ (P < 0.05). The time needed for intubation was significantly shorter with the Pentax-AWS than with the others.

Conclusions

These results suggest that the use of the Pentax-AWS enables tracheal intubation while the patient's chest is rhythmically compressed, and would more often lead to successful intubation, which in turn may lead to more successful resuscitation.     

光学喉镜在急诊气管插管中的临床价值

目的:评价光学喉镜在急诊气管插管中的临床应用价值.方法:将我院2011年1月至2011年7月急诊气管插管的58例患者随机分为观察组(应用Truview/TMEVO2光学喉镜进行气管插管)和对照组(普通喉镜进行气管插管)各29例,比较两组插管效果.结果:两组喉镜使用力量比较、建立有效气道的时间均差异不明显(P＞0.05);观察组气道声门的暴露C/L分级、IDS评分、气管插管过程中SpO2的最低下降值及气管插管后并发症发生率明显优于对照组(P＜0.05).结论:光学喉镜应用于急诊气管插管中可增加气管插管的成功率,减少并发症.     

Cricoid pressure and laryngeal manipulation in 402 pre-hospital emergency anaesthetics: Essential safety measure or a hindrance to rapid safe intubation?

Objectives

This is the first study to look at the effects of cricoid pressure/laryngeal manipulation on the laryngeal view and intubation success in the emergency or pre-hospital environment. Cricoid pressure is applied in the hope of reducing the incidence of aspiration. However the technique has never been evaluated in a randomized trial and may adversely affect laryngeal view. In order to improve intubating conditions cricoid pressure may be released and the larynx manipulated into a more favourable position.

Methods

We carried out a prospective observational study to evaluate the effects of cricoid pressure and laryngeal manipulation on laryngeal view in our physician led pre-hospital trauma service.

Results

402 patients were included over a 16-month period. We intubated 98.8% patients on the first or second attempt. In 61 intubations (in 55 patients, 13.6%) the larynx required manipulation to facilitate intubation. In 22 intubations cricoid pressure was removed with the laryngeal view improving in 50%. Bimanual laryngeal manipulation was used in 25 intubations and the larynx better visualised in 60% of these. Backwards upwards rightwards pressure was applied to the larynx in 14 intubations and the laryngeal view improved in 64%. Two patients regurgitated when cricoid pressure was released. Both had prolonged periods of bag valve mask ventilation and difficult intubations.

Discussion

The results suggest that cricoid pressure should be removed if the laryngeal view obtained is not sufficient to allow immediate intubation. Further manipulation of the larynx is likely to improve the chances of successful tracheal tube placement.     

Comparison of different video laryngoscopes for emergency intubation in a standardized airway manikin with immobilized cervical spine by experienced anaesthetists. A randomized, controlled crossover trial

Background

The aim of the present study was to evaluate whether different video laryngoscopes (VLs) facilitate endotracheal intubation (ETI) faster or more secure than conventional laryngoscopy in a manikin with immobilized cervical spine.

Methods

After local ethics board approval, a standard airway manikin with cervical spine immobilization by means of a standard stiff collar was placed on a trauma stretcher. We compared times until glottic view, ETI, cuff block and first ventilation were achieved, and verified the endotracheal tube position, when using Macintosh laryngoscope, Glidescope Ranger, Storz C-MAC, Ambu Pentax AWS, Airtraq, and McGrath Series5 VLs in randomized order. Wilcoxon signed-rank test and McNemar's test were used for statistical analysis; p < 0.05 was considered as significant.

Results

Twenty-three anaesthetists (mean age 32.1 ± 4.9 years, mean experience in anaesthesia of 6.9 ± 4.8 years) routinely involved in the management of multitrauma patients participated. The primary study end point, time to first effective ventilation, was achieved fastest when using Macintosh laryngoscope (21.0 ± 7.6 s) and was significantly slower with all other devices (Airtraq 33.2 ± 23.9 s, p = 0.002; Pentax AirwayScope 32.4 ± 14.9 s, p = 0.001; Storz C-MAC 34.1 ± 23.9 s, p < 0.001; McGrath Series5 101.7 ± 108.3 s, p < 0.001; Glidescope Ranger 46.3 ± 59.1 s, p = 0.001). Overall success rates were highest when using Macintosh, Airtraq and Storz C-MAC devices (100%), and were lower in Ambu Pentax AWS and Glidescope Ranger (87%, p = 0.5) and in McGrath Series5 device (72.2%, p = 0.063).

Conclusion

When used by experienced anaesthesiologists, video laryngoscopes did not facilitate endotracheal intubation in this model with an immobilized cervical spine in a faster or more secure way than conventional laryngoscopy. However, data was gathered in a standardized model and further studies in real trauma patients are desirable to verify our findings.     

Intubation of prehospital patients with curved laryngoscope blade is more successful than with straight blade

Objective

Direct laryngoscopy can be performed using curved or straight blades, and providers usually choose the blade they are most comfortable with. However, curved blades are anecdotally thought of as easier to use than straight blades. We seek to compare intubation success rates of paramedics using curved versus straight blades.