Adoption of Video Laryngoscopy in Massachusetts Emergency Departments

Raja, Ali S.; Sullivan, Ashley F.; Pallin, Daniel J.; Bohan, J. Stephen; Camargo, Carlos A.

doi:10.1016/j.jemermed.2010.10.020

Cited by 12 publications

(15 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…ED practitioners over that time have relied on DL using the Macintosh or Miller blades. In the past decade multiple studies from North America have highlighted the limitations of DL and have described the benefits of VL …”

Section: Discussionmentioning

confidence: 99%

Comparison of the C‐MAC video laryngoscope with direct Macintosh laryngoscopy in the emergency department

Vassiliadis

Tzannes

Hitos

et al. 2015

Emerg Medicine Australasia

View full text Add to dashboard Cite

This is the first observational study of airway management comparing the C-MAC VL with DL blades in an Australian ED population. Our findings revealed that although the C-MAC VL overall did not provide an enhanced view of the larynx over the Macintosh DL, it was superior to DL when the grade was at least grade III. Currently we are unable to reliably predict the grade by any algorithm prior to intubation. Findings from this study suggest that the C-MAC VL should be considered as the first line laryngoscope in all ED intubations not just the ones predicted to be difficult.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of the C‐MAC video laryngoscope with direct Macintosh laryngoscopy in the emergency department

Vassiliadis

Tzannes

Hitos

et al. 2015

Emerg Medicine Australasia

View full text Add to dashboard Cite

show abstract

“…6-8 One recent study revealed that 43% of EDs affiliated with an emergency medicine residency have a video laryngoscope available. 8 Video laryngoscopes incorporate a micro video camera on the undersurface of the laryngoscope blade and thus bring a view of the airway out of the patient and onto a video monitor. This provides the operator with an indirect view of the airway and thus circumvents the problems associated with achieving a direct line of sight to the airway.…”

Section: Introductionmentioning

confidence: 99%

A Comparison of the C-MAC Video Laryngoscope to the Macintosh Direct Laryngoscope for Intubation in the Emergency Department

Sakles

Mosier

Chiu

et al. 2012

Annals of Emergency Medicine

172

115

View full text Add to dashboard Cite

Study objective We determine the proportion of successful intubations with the C-MAC video laryngoscope (C-MAC) compared with the direct laryngoscope in emergency department (ED) intubations. Methods This was a retrospective analysis of prospectively collected data entered into a continuous quality improvement database during a 28-month period in an academic ED. After each intubation, the operator completed a standardized data form evaluating multiple aspects of the intubation, including patient demographics, indication for intubation, device(s) used, reason for device selection, difficult airway characteristics, number of attempts, and outcome of each attempt. Intubation was considered ultimately successful if the endotracheal tube was correctly inserted into the trachea with the initial device. An attempt was defined as insertion of the device into the mouth regardless of whether there was an attempt to pass the tube. The primary outcome measure was ultimate success. Secondary outcome measures were first-attempt success, Cormack-Lehane view, and esophageal intubation. Multivariate logistic regression analyses, with the inclusion of a propensity score, were performed for the outcome variables ultimate success and first-attempt success. Results During the 28-month study period, 750 intubations were performed with either the C-MAC with a size 3 or 4 blade or a direct laryngoscope with a Macintosh size 3 or 4 blade. Of these, 255 were performed with the C-MAC as the initial device and 495 with a Macintosh direct laryngoscope as the initial device. The C-MAC resulted in successful intubation in 248 of 255 cases (97.3%; 95% confidence interval [CI] 94.4% to 98.9%). A direct laryngoscope resulted in successful intubation in 418 of 495 cases (84.4%; 95% CI 81.0% to 87.5%). In the multivariate regression model, with a propensity score included, the C-MAC was positively predictive of ultimate success (odds ratio 12.7; 95% CI 4.1 to 38.8) and first-attempt success (odds ratio 2.2; 95% CI 1.2 to 3.8). When the C-MAC was used as a video laryngoscope, a Cormack-Lehane grade I or II view (video) was obtained in 117 of 125 cases (93.6%; 95% CI 87.8% to 97.2%), whereas when a direct laryngoscope was used, a grade I or II view was obtained in 410 of 495 cases (82.8%; 95% CI 79.2% to 86.1%). The C-MAC was associated with immediately recognized esophageal intubation in 4 of 255 cases (1.6%; 95% CI 0.4% to 4.0%), whereas a direct laryngoscope was associated with immediately recognized esophageal intubation in 24 of 495 cases (4.8%; 95% CI 3.1% to 7.1%). Conclusion When used for emergency intubations in the ED, the C-MAC was associated with a greater proportion of successful intubations and a greater proportion of Cormack-Lehane grade I or II views compared with a direct laryngoscope.

show abstract

“…In practice, however, the evidence-to-practice gap has been demonstrated in both academic and community medical institutions (18). In previous studies, financial burden has been cited as a barrier to adoption of VL (7). The source of discrepancy between EMR and non-EMR groups in this study is uncertain.…”

Section: Discussionmentioning

confidence: 68%

“…For many years, Emergency Medicine Residency (EMR) programs have focused resident airway training on developing DL skills. Over the last decade, various video laryngoscopy (VL) devices have emerged and are being used with increasing frequency in both EMR programs and non-EMR EDs (1)(2)(3)(4)(5)(6)(7). Whereas DL requires alignment of the pharyngeal, laryngeal, and tracheal axes for proper endotracheal tube placement, VL does not.…”

Section: Introductionmentioning

confidence: 99%

Do Emergency Medicine Residents Receive Appropriate Video Laryngoscopy Training? A Survey to Compare the Utilization of Video Laryngoscopy Devices in Emergency Medicine Residency Programs and Community Emergency Departments

Swaminathan

Berkowitz

Baker

et al. 2015

The Journal of Emergency Medicine

View full text Add to dashboard Cite

Adoption of Video Laryngoscopy in Massachusetts Emergency Departments

Cited by 12 publications

References 13 publications

Comparison of the C‐MAC video laryngoscope with direct Macintosh laryngoscopy in the emergency department

Comparison of the C‐MAC video laryngoscope with direct Macintosh laryngoscopy in the emergency department

A Comparison of the C-MAC Video Laryngoscope to the Macintosh Direct Laryngoscope for Intubation in the Emergency Department

Do Emergency Medicine Residents Receive Appropriate Video Laryngoscopy Training? A Survey to Compare the Utilization of Video Laryngoscopy Devices in Emergency Medicine Residency Programs and Community Emergency Departments

Contact Info

Product

Resources

About