Comparison of the ETView Single Lumen and Macintosh laryngoscopes for endotracheal intubation in an airway manikin with immobilized cervical spine by novice paramedics

Gawłowski, Paweł; Smereka, Jacek; Madziała, Marcin; Cohen, Barak; Ruetzler, Kurt; Szarpak, Łukasz

doi:10.1097/md.0000000000005873

Cited by 23 publications

(38 citation statements)

References 27 publications

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“…100% effectiveness of intubation with the discussed methods was also observed by Gawłowski et al in the cervical spine man-fIGuRe 6. Overall success rate ual immobilisation scenario [12], as well as Truszewski et al intubating patients face to face [20]. The above results are all the more important because the personnel participating in them (physicians, nurses, or paramedics) had no previous experience in videolaryngoscopy.…”

Section: Discussionmentioning

confidence: 96%

VivaSight single-lumen tube as an intubation method. A systematic review and meta-analysis of randomised simulation trials

Karczewska

Smereka

Dąbrowski

et al. 2020

Disaster Emerg Med J

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InTRoDuCTIon:Endotracheal intubation is one of the basic procedures performed in emergency medicine in patients with respiratory insufficiency, inability to maintain airway patency, or apnoea. Rapid performance of the procedure and implementation of ventilation are among the basic principles of rescue procedures. The primary aim of the present systematic review and meta-analysis was to compare the VivaSight single lumen (SL) tube-mounted camera with a standard endotracheal single-lumen tube and direct laryngoscope for endotracheal intubation based on randomised controlled trials of simulation or cadaver trials. The analysis was based on the hypothesis that the use of videolaryngoscopy based on VivaSight SL tube increases the effectiveness of endotracheal intubation, reducing the risk of ineffectiveness of the first intubation attempt and the risk of adverse events, such as dental compression. MATeRIAL AnD MeThoDS:We searched the MEDLINE, EMBASE, Scopus, Cochrane, and Google Scholar databases for randomised, controlled trials and observational studies from 1985 until October 2019, without language restrictions. Grey literature, clinicaltrials.gov, and reference lists of articles were hand searched. We conducted a meta-analysis with random-effects models to evaluate time to intubation, first-pass success rates, overall success rates, dental compression, and glottic view. ReSuLTS:The search located 12 eligible studies. The time of intubation using VivaSight was significantly shorter than that of direct laryngoscopy (MD = -11.29 [-13.10, -9.49], p < 0.001). The efficacy of the first intubation attempt was higher for VivaSight than for double lumen (DL) (96.0% vs. 61.7%; RR = 1.62 [1.40, 1.88], p < 0.001). The meta-analysis showed that the total efficacy of VivaSight intubation compared to direct laryngoscopy was statistically significantly higher (100% vs. 88.9%, RR = 1.11 [1.02, 1.20]; p = 0.02). The glottis visibility assessed as Cormack-Lehane grade I or II was better in VivaSight intubation compared to direct laryngoscopy (100% vs. 90.9%, RR = 1.05 [0.99, 1.12]; p = 0.08). ConCLuSIonS:Our meta-analysis suggests that the VivaSight SL provided better glottic visualisation and shorter intubation time, with improved success rates during different simulated intubation scenarios.

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Section: Discussionmentioning

confidence: 96%

VivaSight single-lumen tube as an intubation method. A systematic review and meta-analysis of randomised simulation trials

Karczewska

Smereka

Dąbrowski

et al. 2020

Disaster Emerg Med J

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“…The effectiveness of this method is confirmed by numerous publications. In Gawlowski et al [20], as in the case of Kurowski et al [13] intubators were able to intubate with ETView SL after a short training session with high efficacy in various emergency scenarios. Also, studies conducted by Truszewski et al [14] indicate high efficacy of ETView intubation under normal conditions, chest compression during simulated cardiopulmonary resuscitation or cervical spine immobilization.…”

Section: Discussionmentioning

confidence: 97%

“…The effectiveness of the first attempt to protect the bronchi with a bronchial blocker was 26% for both scenarios and the total effectiveness of bronchial protection was 100% in both cases. Time T1 for endotracheal intubation was 18sec for Scenario A (IQR; and 20 sec for Scenario B (IQR;[17][18][19][20][21][22][23][24][25]. The time to perform one-lung ventilation (Time T2) in scenarios A and B was 43 sec (IQR; 38-62.5) vs. 43.5 sec (38-65).…”

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confidence: 99%

Successful one-lung ventilation using the VivaSight-EB bronchial blocker tube for an emergency lung injury. A simulation pilot data

Karczewska

Smereka

Szarpak

et al. 2019

Disaster Emerg Med J

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INTRODUCTION:The ability to perform endotracheal intubation is one of the basic skills that paramedics should demonstrate. However, in some cases where lung or bronchial injuries have occurred, it may be necessary to separate the lung by attaching a bronchial blocker and ventilating single lung.The aim of the study was to evaluate the effectiveness of bronchial protection with VivaSight-EB bronchial blocker tube and one-lung ventilation by paramedics in conditions of simulated lung injury. MATERIAL AND METHODS:The study was a prospective randomized cross-over simulation trial in which 27 paramedics took part. In the study, paramedics performed endotracheal intubation with ETView SL and then introduced a VivaSight-EB bronchial blocker and one-lung ventilation. The bronchial protection procedure took place in two scenarios: (A) normal airway; (B) difficult airway. VivaSight-EB bronchial blocker introduction time (T1) and one-lung ventilation time (T2) and the efficacy of the procedure were analysed. RESULTS:The efficacy of endotracheal intubation with ETView SL tube was 100% during both Scenario A and Scenario B. The efficacy of endotracheal intubation with ETView SL tube was 100%. The effectiveness of the first attempt to protect the bronchi with a bronchial blocker was 26% for both scenarios and the total effectiveness of bronchial protection was 100% in both cases. Time T1 for endotracheal intubation was 18sec for Scenario A (IQR; and 20 sec for Scenario B (IQR;[17][18][19][20][21][22][23][24][25]. The time to perform one-lung ventilation (Time T2) in scenarios A and B was 43 sec (IQR; 38-62.5) vs. 43.5 sec (38-65). CONCLUSIONS:The simulation study confirmed the research hypothesis that the paramedics were able to perform one-lung ventilation using the ETView-Blocker® bronchial blocker tube after a short training.

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“…It should be remembered that each intubation performed within an emergency medical service is emergency intubation (24). The lack of information on patient status and medical history, inability to conduct an anesthesia consultation in many cases, as well as the lack of knowledge of the recent meal, make each patient in the pre-hospital conditions and the emergency department considered as a patient with difficult airways (25). In our study, the efficacy of the first intubation attempt and the total efficacy of intubation under normal airway were comparable for direct laryngoscopy and McGrath videolaryngoscopy.…”

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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Comparison of the ETView Single Lumen and Macintosh laryngoscopes for endotracheal intubation in an airway manikin with immobilized cervical spine by novice paramedics

Cited by 23 publications

References 27 publications

VivaSight single-lumen tube as an intubation method. A systematic review and meta-analysis of randomised simulation trials

VivaSight single-lumen tube as an intubation method. A systematic review and meta-analysis of randomised simulation trials

Successful one-lung ventilation using the VivaSight-EB bronchial blocker tube for an emergency lung injury. A simulation pilot data

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

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