Can GlideScope® videolaryngoscope be an alternative to direct laryngoscopy for child and infant tracheal intubation during chest compression?

Szarpak, Łukasz; Czyżewski, Łukasz; Kurowski, Andrzej

doi:10.1007/s00431-015-2495-7

Cited by 10 publications

(4 citation statements)

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“…Endotracheal intubation in pre-hospital settings can be challenging even for experienced intubators (22,23). It should be remembered that each intubation performed within an emergency medical service is emergency intubation (24).…”

Section: Discussionmentioning

confidence: 99%

Comparison of the McGrath MAC EMS Videolaryngoscope with a Conventional Laryngoscope for Standard and Difficult Airway Intubation: A Randomized, Cross-over, Simulation Trial

Korkut¹,

Szarpak²,

Evrın³

et al. 2019

Eurasian J Emerg Med

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IntroductionTracheal intubation is the gold standard for airway management. The advantages of endotracheal intubation include reliable ventilation, separation of the airway from the gastrointestinal tract, significant reduction of regurgitation risk, the possibility to suction the respiratory tract, and to ventilate in further patient care conditions, including intensive care units (1,2). Endotracheal intubation can be performed with many techniques, but direct Aim: Tracheal intubation is challenging in emergency medicine, especially in pre-hospital settings, owing to problems connected with patients, intubator, and the environment. The study aimed to compare the effectiveness of endotracheal intubation performed by paramedics with the use of direct laryngoscopy and the McGrath MAC videolaryngoscope in standard and difficult airway settings. Materials and Methods:The study was designed as a prospective, randomized, cross-over simulation study. It involved 52 paramedics. The participants performed endotracheal intubation in two scenarios: Normal airway and difficult airway, achieved by inflation of the simulator tongue to the level of difficulty determined by an independent instructor at grade 3 on the Cormack-Lehane scale. The primary endpoint was the success of endotracheal intubation; intubation time constituted the secondary endpoint. Results:The median age of participants was 24 years [interquartile range (IQR): 23-25], and the median work experience was 0.5 years (IQR: 0-1). In normal airway (scenario A), the effectiveness of the first intubation attempt was 92.3% for MAC and 96.2% for McGrath (p=0.724). The median intubation time for MAC was 19 (IQR: 14-21.5) seconds and was statistically significantly longer than 16 (12.5-20) seconds for McGrath (p=0.047). The ease of intubation was 18 (IQR: 10-20) points for McGrath and 25 (IQR: 16-27) points for MAC (p=0.035). In difficult airway (scenario B), the efficacy of the first intubation attempt for MAC and McGrath equaled 40.4% and 82.7%, respectively. The median intubation time for McGrath was 19 (IQR: 14-27.5) seconds and was significantly shorter than 25 (IQR: 24-39) seconds for MAC (p=0.007). The degree of glottis visualization was statistically significantly better in McGrath than in MAC (p<0.001). The ease of intubation was 25 (IQR: 20-32) points for McGrath and 49 (IQR: 34-58) points for MAC (p<0.001). Overall, 96.2% of subjects intubating in difficult airway conditions chose the McGrath videolaryngoscope as their preferred intubation method as compared with MAC. Conclusion:In the simulation study, endotracheal intubation in difficult airway conditions performed by paramedics using McGrath video laryngoscopy was associated with shorter procedure duration, better glottis visualization, and higher efficacy of the first intubation attempt. The study showed that paramedics were able to intubate using the McGrath videolaryngoscope with higher efficiency than in the case of a standard Macintosh laryngoscope after a short training.

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Section: Discussionmentioning

confidence: 99%

Comparison of the McGrath MAC EMS Videolaryngoscope with a Conventional Laryngoscope for Standard and Difficult Airway Intubation: A Randomized, Cross-over, Simulation Trial

Korkut¹,

Szarpak²,

Evrın³

et al. 2019

Eurasian J Emerg Med

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“…The slower replacement time with the SALT for an endotracheal tube may be because of the SALT's lack of a cuff, thus eliminating the time for cuff emptying. For comparison of the simulated child CPR studies by Szarpak et al, [ 22 ] intubation efficacy using the Miller laryngoscope was 55% with a mean duration time to intubation of 37 seconds. Beleña et al evaluates replacing the laryngeal tube and the Ambu AuraOnce laryngeal mask for an endotracheal tube using the Frova introducer.…”

Section: Discussionmentioning

confidence: 99%

Exchange of supraglottic airways for endotracheal tube using the Eschmann Introducer during simulated child resuscitation

Szarpak

Truszewski²,

Vitale³

et al. 2017

Medicine

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Background:The aim of this study was to examine the application of the Eschmann tracheal tube introducer (ETTI) with 4 types of supraglottic airway devices (SADs) using a child-manikin.Methods:A total of 79 paramedics were asked to exchange the 4 SADs for an endotracheal tube with the ETTI in 3 different scenarios using a randomized crossover study format: normal airway without chest compression; normal airway with uninterrupted chest compression; and difficult airway with uninterrupted chest compression. The primary outcome was time to SAD exchange, with the secondary outcome measuring the success of SAD exchange. Each attempt was assessed by a trained assistant.Results:The mean exchange times for LMA, Cobra PLA, Air-Q, and SALT were as follows: 21, 23, 21, and 18, respectively for Scenario A; 23, 27, 22.5, and 21 for Scenario B; and 23, 28, 23, and 23 for Scenario C. The percent efficacy of SADs exchange with LMA, Cobra PLA, Air-Q and SALT were 98.7%, 94.9%, 100%, and 100% for scenario A; 98.7%, 88.6%, 98.7%, and 97.5% for scenario B; and 93.7%, 87.3%, 94.9%, and 93.7% for scenario C.Conclusions:In this model of pediatric resuscitation, the SAD exchange using an ETTI has (LMA, Cobra PLA, Air-Q and SALT) proved to be effective in paramedics with no previous experience. Furthermore, experimental findings indicated that SAD exchange can be achieved without interrupting chest compression.

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“…[13] czas niezbędny na wykonanie intubacji za pomocą laryngoskopu z łopatką Millera podczas RKO wynosił 28,2 s (IQR, 20,4-34,4), zaś w badaniach Szarpaka i wsp. 35,4 s [14].…”

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Porównanie skuteczności Pentax AWS S-100 i laryngoskopu z łopatką Macintosha podczas intubacji dotchawiczej dziecka w warunkach symulowanej resuscytacji – badanie randomizowane

et al. 2015

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Can GlideScope® videolaryngoscope be an alternative to direct laryngoscopy for child and infant tracheal intubation during chest compression?

Cited by 10 publications

References 1 publication

Comparison of the McGrath MAC EMS Videolaryngoscope with a Conventional Laryngoscope for Standard and Difficult Airway Intubation: A Randomized, Cross-over, Simulation Trial

Comparison of the McGrath MAC EMS Videolaryngoscope with a Conventional Laryngoscope for Standard and Difficult Airway Intubation: A Randomized, Cross-over, Simulation Trial

Exchange of supraglottic airways for endotracheal tube using the Eschmann Introducer during simulated child resuscitation

Porównanie skuteczności Pentax AWS S-100 i laryngoskopu z łopatką Macintosha podczas intubacji dotchawiczej dziecka w warunkach symulowanej resuscytacji – badanie randomizowane

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