Comparison of the time to successful endotracheal intubation using the Macintosh laryngoscope or KingVision video laryngoscope in the emergency department: A prospective observational study

Mallick, Tanvi; Verma, Ankur; Jaiswal, Sanjay; Haldar, Meghna; Sheikh, Wasil Rasool; Vishen, Amit Singh; Snehy, Abhishek; Ahuja, Rinkey

doi:10.4103/2452-2473.276381

Cited by 14 publications

(8 citation statements)

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“…The effectiveness of endotracheal intubation performed in the emergency medicine setting, as indicated by numerous publications, is insufficient [1,2]. This is especially true for intubation performed in the pre-hospital setting.…”

Section: Discussionmentioning

confidence: 99%

“…Airway management is a key element of the resuscitation process but unfortunately the first-pass success of emergency intubations are inconsistent and relatively low. Studies by Suzuki et al [1] and Mallick et al [2] from emergency departments found first-pass ISR using the Macintosh direct laryngoscope between 58% and 90%. Endotracheal intubation in a pre-hospital setting maybe even less effective, which is influenced by time pressure, unfavorable weather conditions, often the lack of optimal access to the patient, as well as other factors [3,4].…”

Section: Introductionmentioning

confidence: 97%

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Direct vs. Video-Laryngoscopy for Intubation by Paramedics of Simulated COVID-19 Patients under Cardiopulmonary Resuscitation: A Randomized Crossover Trial

Gadek¹,

Szarpak

Konge

et al. 2021

JCM

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A safe way of securing the airway with an endotracheal tube is one of the priorities of an advanced cardiovascular life support algorithm for suspected or confirmed COVID-19 patients. The aim of this study was to compare intubation success rates (ISR) and intubation time (IT) of different laryngoscopes for simulated COVID-19 patients under cardiopulmonary resuscitation. The study was designed as a prospective, randomized, crossover trial. Fifty four active paramedics performed endotracheal intubation with a Macintosh direct laryngoscope (MAC) and McGrath videolaryngoscope (McGrath) with and without personal protective equipment (PPE). Without PPE, ISRs were 87% and 98% for MAC and McGrath, respectively (p = 0.32). ITs were 22.5 s (IQR: 19–26) and 19.5 s (IQR: 17–21) for MAC and McGrath, respectively (p = 0.005). With PPE, first-pass ISR were 30% and 89% with MAC and McGrath, respectively (p < 0.001). The overall success rates were 83% vs. 100% (p = 0.002). Median ITs were 34.0 s (IQR: 29.5–38.5) and 24.8 s (IQR: 21–29) for MAC and McGrath, respectively (p < 0.001). In conclusion, the McGrath videolaryngoscope appears to possess significant advantages over the Macintosh direct laryngoscope when used by paramedics in suspected or confirmed COVID-19 intubation scenarios.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Direct vs. Video-Laryngoscopy for Intubation by Paramedics of Simulated COVID-19 Patients under Cardiopulmonary Resuscitation: A Randomized Crossover Trial

Gadek¹,

Szarpak

Konge

et al. 2021

JCM

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“…Airway management is one of the key skills that medical personnel should master, especially by emergency medical service teams. As shown by many studies, the effectiveness of endotracheal intubation in emergency medicine conditions is insufficient, ranging from 57.6% to 89.9% [1,2]. However, in the situation of the current SARS-CoV-2 pandemic, medical personnel should treat each patient in pre-hospital conditions as a potentially infected patient, therefore they should perform medical procedures wearing personal protective equipment (PPE) for aerosol generating procedures (AGPs) [3,4].…”

Section: To the Editormentioning

confidence: 99%

Airway Management in Personal Protective Equipment Conditions

Rafique

Szarpak

Chirico

et al. 2021

Advances in Respiratory Medicine

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“…Emergency intubation based on direct laryngoscopy arouses a high risk of failure. As many authors indicate, the effectiveness of the first intubation attempt with a Macintosh laryngoscope is 57.6% [4], 84.4% [5], 89.94% [6]. The issue concerns not only adults but also pediatric patients [7].…”

Section: Introductionmentioning

confidence: 99%

VieScope® laryngoscope versus Macintosh laryngoscope during difficult intubation performed by paramedics: a randomized cross-over manikin trial

Maslanka¹,

Smereka

Czyżewski

et al. 2020

Disaster Emerg Med J

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INTRODUCTION: The aim of this study was to evaluate intubation performance by paramedics using Macintosh laryngoscope and VieScope ® laryngoscope under simulated difficult airway conditions. METHODS: In a randomized, single-blinded, cross-over simulation trial, 42 paramedics performed endotracheal intubation using VieScope ® and Macintosh (MAC) laryngoscopes in two difficult airway scenarios: (A) tongue edema, (B) manual cervical inline stabilization. The order of participants and intubation methods was random. Time to ventilation constituted the primary outcome, and the secondary outcomes were the success rate of first intubation attempt, overall intubation success rate, Cormack and Lehane grade, and ease of use. RESULTS: In scenario A, the median overall intubation time was 55s (46-109) in the MAC group and 30.5s (26-35) in the VieScope ® group (p < 0.001). The efficacy of the first intubation attempt with MAC and VieScope ® varied and amounted to 64.3% vs. 95.2% (p < 0.001). During scenario B, VieScope ® offered better intubation conditions than MAC (p < 0.001), including shorter intubation time, higher first attempt and overall intubation success rates, as well as better glottic view. CONCLUSIONS: In this simulation trial, we found that VieScope ® could be successfully used for intubation in difficult airways by paramedics with little simulation experience with this device. VieScope ® was associated with shorter time and higher success rates of intubation attempt compared with MAC. Nevertheless, we recommend that the performance of VieScope ® and MAC should be further evaluated in the clinical setting to confirm our results.

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Comparison of the time to successful endotracheal intubation using the Macintosh laryngoscope or KingVision video laryngoscope in the emergency department: A prospective observational study

Cited by 14 publications

References 0 publications

Direct vs. Video-Laryngoscopy for Intubation by Paramedics of Simulated COVID-19 Patients under Cardiopulmonary Resuscitation: A Randomized Crossover Trial

Direct vs. Video-Laryngoscopy for Intubation by Paramedics of Simulated COVID-19 Patients under Cardiopulmonary Resuscitation: A Randomized Crossover Trial

Airway Management in Personal Protective Equipment Conditions

VieScope® laryngoscope versus Macintosh laryngoscope during difficult intubation performed by paramedics: a randomized cross-over manikin trial

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