Laryngoscopes for difficult airway scenarios: a comparison of the available devices

Abstract

According to the American Society of Anesthesiologists, the incidence of difficult intubation in the operating room is 1.2-3.8%; however, in emergency conditions, this rate is higher and reaches even 5.3%. Successful emergency airway management is an essential component of the modern practice of medicine. Areas covered: The aim of the study is to review the literature regarding different devices used to perform endotracheal intubation (Macintosh, Miller, and McCoy laryngoscopes; ETView, GlideScope, TruView, Airtraq, McGrath MAC, Pentax AWS, Trachlight, Shikani, and Bullard) and discuss their clinical and experimental role in difficult airway management. Expert commentary: Owing to the development of medical technology, there are an increasing number of videolaryngoscopes and other devices facilitating endotracheal intubation in difficult airway scenarios, including cardiopulmonary resuscitation, cervical spine injury, or face-to-face intubation. Each of these devices may bring benefits in the form of increasing the intubation effectiveness, as well as shortening the procedure, provided that the person performing intubation is familiar with the use of the device.

Efficacy of double-lumen intubation performed by paramedics on patients with lung damage. Experimental, pilot simulation trial

“…Double-lumen intubation and one-lung ventilation are highly specialized procedures [10][11][12]. Due to the technique of this intubation as well as the higher costs of the equipment necessary to perform intubation compared to standard endotracheal tube, it is rarely used in pre-hospital conditions [ 3 ]. However, the development of medical technology and the development of video laryngoscopes and intubation tubes with built-in video circuits -including double-lumen tubes -may change this trend [13,14].…”

“…Airway management has always been one of the key elements of emergency procedures [1][2][3]. In many situations, including cardiopulmonary resuscitation, endotracheal intubation is recognized by such scientific societies as American Heart Association (AHA) or European Resuscitation Council (ERC) as the gold standard for airway management during resuscitation procedures [4,5].…”

Videolaryngoscopy post COVID-19

“…Formally integrating training in videolaryngoscopy, could play a crucial part in our preparedness to deal with future challenges [ 20 ]. Videolaryngoscopy requires fewer attempts to achieve proficiency, and evidence shows that novices found videolaryngoscopy easier to use than direct laryngoscopy [ 21 , 22 ]. This could mean that the most experienced intubators available could gain skills and expertise with videolaryngoscopy and be confident in its use in the event of another highly contagious pandemic.…”

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

“…The development of videolaryngoscope marked significant progress in anesthesiology and emergency medicine (9,10). The devices enable endotracheal intubation even when the entrance to the larynx cannot be directly visualized (11).…”