C-MAC videolaryngoscope compared with direct laryngoscopy for rapid sequence intubation in an emergency department

Sulser, Simon; Ubmann, Dirk; Schläpfer, Martin; Brueesch, Martin; Goliasch, Georg; Seifert, Burkhardt; Spahn, Donat R.; Ruetzler, Kurt

doi:10.1097/eja.0000000000000525

Cited by 83 publications

(71 citation statements)

References 22 publications

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“…This finding is in line with several previous publications, reporting better airway visualization by using videolaryngoscopes [12,[24][25][26]. Although there is increasing evidence that better airway visualization may lead to a higher intubation success rate, this effect may be limited to relatively low-experienced healthcare providers.…”

Section: Discussionsupporting

confidence: 92%

“…Our study therefore confirms previous studies, reporting videolaryngoscopes to be superior compared such as anaesthesiologists may not benefit to this extent, as these healthcare providers are very familiar with direct laryngoscopy and achieve high success rate with both techniques [12,27]. However, initial intubation attempt and overall success rate by our inexperienced physicians were much higher when compared with direct laryngoscopy using the Macintosh blade.…”

Section: Discussionsupporting

confidence: 87%

“…Videolaryngoscopy has been introduced into clinical practice to ultimately ease endotracheal intubation by better visualization of the airway [12]. Several videolaryngoscopes are currently available which differ in the design and angle of the blade.…”

Section: A B Cmentioning

confidence: 99%

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ET-View compared to direct laryngoscopy in patients with immobilized cervical spine by unexperienced physicians: A randomized crossover manikin trial

Karczewska¹,

Szarpak²,

Smereka³

et al. 2014

Anaesthesiol Intensive Ther

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Background: Immobilization of the cervical spine is indicated in all patients with the potential risk of any cervical spine injury. Airway management in these patients is challenging and direct laryngoscopy is the standard of care. Videolaryngoscopes like the ET-View were introduced into clinical practice to provide better airway visualization and ease intubation. Although the ET-View is essentially a conventional endotracheal tube, it is equipped with a miniature camera in its tip. The ET-View has not been investigated in patients with immobilized cervical spine so far. The aim was to evaluate the performance of the VivaSight SL compared with Macintosh when performed in patients with immobilized cervical spine by inexperienced physicians. Methods: This was a prospective, randomized, cross-over manikin trial. Fifty novice physicians were randomly assigned to intubate a manikin in three airway scenarios including a normal airway and two cervical immobilization techniques. The overall and first intubation attempt success rate, time to intubation, dental compression and airway visualization according to the Cormack and Lehane classification were assessed. Results: All physicians were able to intubate the manikin in all scenarios using the ET-View, whereas direct laryngoscopy failed in 16% with immobilized cervical spine using the patriot cervical extraction collar. The first intubation attempt success rate was higher and airway visualization was better in all three scenarios using the ET-View compared to direct laryngoscopy. Conclusion:The ET-View offered much better 62 airway visualization and provided higher overall and first intubation attempt success rates. Therefore, the ET-View is a valuable alternative in patients with difficult intubation due to immobilized cervical spine. Further clinical trials are indicated to confirm these findings.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 87%

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ET-View compared to direct laryngoscopy in patients with immobilized cervical spine by unexperienced physicians: A randomized crossover manikin trial

Karczewska¹,

Szarpak²,

Smereka³

et al. 2014

Anaesthesiol Intensive Ther

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“…Fortunately, we have other recently published randomized trials of VL in critically ill adults showing that our result was not likely a result of our study design. The findings are the same across the board: routine use of VL during endotracheal intubation of critically ill adults improves laryngeal visualization but does not increase procedural success or decrease complications (3, 4, 5). …”

mentioning

confidence: 68%

The authors reply

Janz

Semler

Rice

2017

Critical Care Medicine

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“…Unfortunately, supposition that the angle of the blade rather than glottic view is the truly meaningful intervention is only speculative and this assertion differs from the fundamental argument in favor of VL expressed by experts, specifically that VL provides a superior view of the glottis (3). In addition, the existing data from randomized trials of devices with hyperangulated blades mentioned by Latif et al all show that these hyperangulated blades do not improve success (4) or may even be harmful (5). Finally, Latif et al cite a previous study (6) using GlideScope ® as the only VL device as evidence that hyperangulated blades may be superior to direct laryngoscopes with curved blades.…”

mentioning

confidence: 99%