SummaryUnanticipated difficulties during tracheal intubation and failure to intubate are among the leading causes of anaesthesia-related morbidity and mortality. Using the technique of video laryngoscopy, the alignment of the oral and pharyngeal axes to facilitate tracheal intubation is unnecessary. In this study we evaluated the McGrath Ò Series 5 videolaryngoscope for tracheal intubation in 61 patients who exhibited Cormack and Lehane grade 3 or 4 laryngoscopies with a Macintosh laryngoscope. Using the McGrath resulted in an improved glottic view, compared to Macintosh laryngoscope. Laryngoscopy was improved by one grade in 10%, by two grades in 80% and by three grades in 10% of cases (p < 0.0001). The success rate for intubation was 95% with the McGrath. These results suggest that the McGrath videolaryngoscope can be used with a high success rate to facilitate tracheal intubation in difficult intubation situations.

The McGrath video-laryngoscope was used in a patient with immobilized cervical spine and suspected difficult airway after a high level fall with traumatic brain injury and suspected cervical spine trauma. The airway was successfully secured in the preclinical setting using an oral endotracheal tube with full view of the glottis. Because video-laryngoscopy offers potential advantages compared to established airway management techniques, further studies are required to evaluate the significance of video-laryngoscopy in prehospital emergency medicine.

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