Esophageal intubation with indirect clinical tests during emergency tracheal intubation: a report on patient morbidity

Mort, Thomas C.

doi:10.1016/j.jclinane.2005.02.004

Cited by 85 publications

(81 citation statements)

References 19 publications

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“…These findings suggest the need for caution with the use of this score with indirect laryngoscopes. Difficult tracheal intubation remains a major source of morbidity and mortality, in the operating theatre [1][2][3] and in the emergency setting [4,5]. Difficult or failed tracheal intubation is an important cause of anaesthetic death and brain damage [6][7][8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Determination of the utility of the Intubation Difficulty Scale for use with indirect laryngoscopes

McElwain¹,

Simpkin

Laffey³

2011

Anaesthesia

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SummaryThe purpose of this study was to determine whether the Intubation Difficulty Scale is meaningful when used with indirect laryngoscopes. Data were analysed from previously published clinical trials from our group that compared the indirect laryngoscopes with the Macintosh laryngoscope. For each laryngoscope type, the Intubation Difficulty Scale score obtained for each tracheal intubation was correlated with data for duration of the intubation attempt and with the user rated difficulty of the intubation attempt. The strengths of the correlations between these indices were then compared for tracheas intubated with the Macintosh vs the indirect laryngoscopes. The Intubation Difficulty Scale performed well when compared with data for duration and user rated difficulty of the intubation attempts for the both direct and indirect laryngoscopy. However, the correlation between the Intubation Difficulty Scale score and both user rated difficulty (p = 0.001) and the duration of tracheal intubation (p = 0.003) were significantly stronger for the Macintosh laryngoscope compared with the indirect laryngoscopes. In contrast, the correlation between user rated difficulty scores and the data for duration of tracheal intubation was not different between the device types. The Intubation Difficulty Scale performs less well with indirect laryngoscopes than with the Macintosh laryngoscope. These findings suggest the need for caution with the use of this score with indirect laryngoscopes. Difficult tracheal intubation remains a major source of morbidity and mortality, in the operating theatre [1][2][3] and in the emergency setting [4,5]. Difficult or failed tracheal intubation is an important cause of anaesthetic death and brain damage [6][7][8][9][10][11]. These issues have stimulated the development of 'indirect' laryngoscopes, with the aim of reducing the difficulty obtaining a laryngeal view. Many such devices now exist on the market, including the Glidescope [12, 13], Airtraq [14], Pentax Airway Scope (AWS) [12,15,16], TruView [12,16], and LMA C-Trach [17]. One difficulty encountered investigating the utility of these devices is the lack of a gold standard descriptor for intubation difficulty. While indices such as the duration of tracheal intubation attempts and user rated scores of the difficulty of laryngoscopy and intubation are useful, they do not provide a complete picture. A more objective scoring system might serve as a reproducible quantitative means of overcoming some of these limitations.Adnet et al. proposed the Intubation Difficulty Scale (IDS), which incorporates seven parameters (see Appendix 1) [18], for use when describing direct laryngoscopy and intubation. More recently, the IDS has been used to describe difficulty of laryngoscopy and tracheal intubation with indirect laryngoscopes in multiple studies by our group [13,16,17] and others [15,19]. However, the validity of the IDS when used with indirect laryngoscopes has not been evaluated.

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Section: Discussionmentioning

confidence: 99%

Determination of the utility of the Intubation Difficulty Scale for use with indirect laryngoscopes

McElwain¹,

Simpkin

Laffey³

2011

Anaesthesia

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“…18 The occurrence of difficulties and/or failure to intubate the trachea successfully in these situations constitutes an important cause of complications, such as airway trauma, esophageal intubation, hypoxia, pulmonary aspiration, and adverse hemodynamic events. 8,9,19 In recent years, advances in optical technologies have facilitated the development of multiple novel indirect laryngoscopes. A common feature of these devices is that they visualize the glottis by indirect mechanisms, obviating the need to align the oral, pharyngeal, and tracheal axes and thereby potentially making laryngeal visualization and subsequent tracheal intubation easier to perform.…”

Section: Discussionmentioning

confidence: 99%

“…Difficult or failed tracheal intubation in this context constitutes an important cause of morbidity arising from direct airway trauma and the systemic complications of hypoxia. 8,9 The Airway Scope Ò (AWS Ò ; Pentax Corporation, Tokyo, Japan) is a novel system for tracheal intubation that provides a view of the glottis without requiring alignment of oral, pharyngeal, and laryngeal axes (Fig. 1a).…”

Section: Résumémentioning

confidence: 99%

A comparison of the Glidescope®, Pentax AWS®, and Macintosh laryngoscopes when used by novice personnel: a manikin study

Malik

Hassett

Carney

et al. 2009

Can J Anesth/J Can Anesth

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“…In the prehospital setting, paramedics may need to perform tracheal intubation in patients with a reduced level of consciousness, often due to trauma or cardiac arrest, or in difficult situations such as lying on the ground, in confined spaces and even in the sitting position. Difficult or failed tracheal intubation is an important cause of morbidity [1,2], especially when performed by those who undertake this procedure infrequently. The gold standard device used for intubation is the Macintosh laryngoscope [3].…”

mentioning

confidence: 99%

A paramedic study comparing the use of the Airtraq^®, Airway Scope and Macintosh laryngoscopes in simulated prehospital airway scenarios*

Lewis¹,

Hodzovic

Whelan³

et al. 2010

Anaesthesia

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SummaryIn a randomised, cross-over study, we compared the use of the Airtraq Ò , Airway Scope and Macintosh laryngoscopes by paramedics for tracheal intubation in three simulated prehospital scenarios. Fifty-four paramedics were invited to take part. When evaluated in a difficult airway manikin, median IQR [range] 120] s; p < 0.0001). The success rate within 30 s was greater with the Airtraq (61%) and Airway Scope (93%) than with the Macintosh laryngoscope (22%; p < 0.0001). When used for a standard intubation and in the sitting position, we found minimal differences among the three laryngoscopes. We conclude that the Airway Scope and Airtraq have significant advantages over the Macintosh laryngoscope and that of the two, the Airway Scope is the more effective device to use in the prehospital environment.

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Esophageal intubation with indirect clinical tests during emergency tracheal intubation: a report on patient morbidity

Cited by 85 publications

References 19 publications

Determination of the utility of the Intubation Difficulty Scale for use with indirect laryngoscopes

Determination of the utility of the Intubation Difficulty Scale for use with indirect laryngoscopes

A comparison of the Glidescope®, Pentax AWS®, and Macintosh laryngoscopes when used by novice personnel: a manikin study

A paramedic study comparing the use of the Airtraq^®, Airway Scope and Macintosh laryngoscopes in simulated prehospital airway scenarios*

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Esophageal intubation with indirect clinical tests during emergency tracheal intubation: a report on patient morbidity

Cited by 85 publications

References 19 publications

Determination of the utility of the Intubation Difficulty Scale for use with indirect laryngoscopes

Determination of the utility of the Intubation Difficulty Scale for use with indirect laryngoscopes

A comparison of the Glidescope®, Pentax AWS®, and Macintosh laryngoscopes when used by novice personnel: a manikin study

A paramedic study comparing the use of the Airtraq®, Airway Scope and Macintosh laryngoscopes in simulated prehospital airway scenarios*

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Product

Resources

About

A paramedic study comparing the use of the Airtraq^®, Airway Scope and Macintosh laryngoscopes in simulated prehospital airway scenarios*