A Prospective Cohort Study Comparing Medical Student Intubation on Cadaveric and Manikin Models Using the King Vision™ Videolaryngoscope and Direct Laryngoscopy

Abstract

Objective: Compare intubation by medical students with direct laryngoscopy (DL) versus King Vision™ videolaryngoscope in training and cadaveric models.Methods: 24 medical students with no experience intubating humans were randomized into two groups: DL first or King Vision™ videolaryngoscope first. Following a short training, techniques were practiced ona manikin model. Intubation success, ease of use, and one timed manikin intubation was recorded. Students crossed, repeated training and trial with other technique. Students then intubated 3 cadavers with their initial technique, crossed over to intubate these same cadavers using their second technique. Cormack-Lehane (C-L) view of the glottic opening, time to intubation, intubation success, ease of use, and preferred technique were recorded. Results:In manikin intubation, success rate was not significantly different. Mean time to intubation using DL was 19.67 seconds, 11.03 seconds with King Vision™. The median "ease of use" for DL was 7; King Vision™ was 4 (0 easiest, 10 hardest). In cadaver model, the median C-L view was 2 for DL, 1 for King Vision™. Success rates were 82% for DL and 93% for King Vision™. The median "ease of use" for DL was 5 and King Vision™ was 4. Conclusion:The King Vision™ videolaryngoscope had statistically significant improved visualization of the glottic opening, intubation success rate when compared to DL, and was rated easier to use. Given the portable nature, low cost, ease of use, and easy maintenance; the King Vision™ videolaryngoscope should be considered an excellent device for intubation training orany emergent setting where advanced airway management is required.

Comparison of King Vision video laryngoscope (channeled blade) with Macintosh laryngoscope for tracheal intubation using armored endotracheal tubes

“…[111213] It may be because of the inappropriate method of insertion of VL or too distal insertion of blade tip leading to discordant alignment between glottis and path of ETT. [14] In our study we followed the recommended procedure of device use and found no difficulty in ETT insertion. The only problem with KVVL is fogging of distal lens affecting the image clarity.…”