scholarly journals The Usefulness of Design of Experimentation in Defining the Effect Difficult Airway Factors and Training Have on Simulator Oral-Tracheal Intubation Success Rates in Novice Intubators

2010 ◽  
Vol 17 (4) ◽  
pp. 460-463 ◽  
Author(s):  
Frank Thomas ◽  
Judi Carpenter ◽  
Carol Rhoades ◽  
Renee Holleran ◽  
Gregory Snow
Keyword(s):  
Tracheal Intubation ◽  
Difficult Airway ◽  
Success Rates ◽  
Intubation Success ◽  
And Training

scholarly journals Comparative Effectiveness of the C-MAC Video Laryngoscope versus  Direct Laryngoscopy in the Setting of the Predicted Difficult Airway

2012 ◽  
Vol 116 (3) ◽  
pp. 629-636 ◽  
Author(s):  
Michael F. Aziz ◽  
Dawn Dillman ◽  
Rongwei Fu ◽  
Ansgar M. Brambrink
Keyword(s):  
Tracheal Intubation ◽  
Difficult Airway ◽  
Difficult Intubation ◽  
Direct Laryngoscopy ◽  
Controlled Trial ◽  
Video Laryngoscope ◽  
Video Laryngoscopy ◽  
Success Rates ◽  
Intubation Success ◽  
Intubation Success Rate

Background Video laryngoscopy may be useful in the setting of the difficult airway, but it remains unclear if intubation success is improved in routine difficult airway management. This study compared success rates for tracheal intubation with the C-MAC® video laryngoscope (Karl Storz, Tuttlingen, Germany) with conventional direct laryngoscopy in patients with predicted difficult airway. Methods We conducted a two arm, single-blinded randomized controlled trial that involved 300 patients. Inclusion required at least one of four predictors of difficult intubation. The primary outcome was successful tracheal intubation on first attempt. Results The use of video laryngoscopy resulted in more successful intubations on first attempt (138/149; 93%) as compared with direct laryngoscopy (124/147; 84%), P = 0.026. Cormack-Lehane laryngeal view was graded I or II in 139/149 of C-MAC attempts versus 119/147 in direct laryngoscopy attempts (P < 0.01). Laryngoscopy time averaged 46 s (95% CI, 40-51) for the C-MAC group and was shorter in the direct laryngoscopy group, 33 s (95% CI, 29-36), P < 0.001. The use of a gum-elastic bougie and/or external laryngeal manipulation were required less often in the C-MAC intubations (24%, 33/138) compared with direct laryngoscopy (37%, 46/124, P = 0.020). The incidence of complications was not significantly different between the C-MAC (20%, 27/138) versus direct laryngoscopy (13%, 16/124, P = 0.146). Conclusion A diverse group of anesthesia providers achieved a higher intubation success rate on first attempt with the C-MAC in a broad range of patients with predictors of difficult intubation. C-MAC laryngoscopy seems to be a useful technique for the initial approach to a potentially difficult airway.

scholarly journals Awake Fiberoptic or Awake Video Laryngoscopic Tracheal Intubation in Patients with Anticipated Difficult Airway Management

2012 ◽  
Vol 116 (6) ◽  
pp. 1210-1216 ◽  
Author(s):  
Charlotte V. Rosenstock ◽  
Bente Thøgersen ◽  
Arash Afshari ◽  
Anne-Lise Christensen ◽  
Claus Eriksen ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Difficult Airway ◽  
Scale Score ◽  
Visual Analog Scale ◽  
Difficult Intubation ◽  
Visual Analog Scale Score ◽  
Difficult Tracheal Intubation ◽  
Fiberoptic Intubation ◽  
Analog Scale ◽  
Intubation Success

Background Awake flexible fiberoptic intubation (FFI) is the gold standard for management of anticipated difficult tracheal intubation. The purpose of this study was to compare awake FFI to awake McGrath® video laryngoscope, (MVL), (Aircraft Medical, Edinburgh, Scotland, United Kingdom) intubation in patients with an anticipated difficult intubation. The authors examined the hypothesis that MVL intubation would be faster than FFI. Methods Ninety-three adult patients with anticipated difficult intubation were randomly allocated to awake FFI or awake MVL, patients were given glycopyrrolate, nasal oxygen, topical lidocaine orally, and a transtracheal injection of 100 mg lidocaine. Remifentanil infusion was administered intravenously to a Ramsay sedation score of 2-4. Time to tracheal intubation was recorded by independent assessors. The authors also recorded intubation success on the first attempt, investigators' evaluation of ease of the technique, and patients reported intubation-discomfort evaluated on a visual analog scale. Results Eighty-four patients were eligible for analysis. Time to tracheal intubation was median [interquartile range, IQR] 80 s [IQR 58-117] with FFI and 62 s [IQR 55-109] with MVL (P = 0.17). Intubation success on the first attempt was 79% versus 71% for FFI and MVL, respectively. The median visual analog scale score for ease of intubation was 2 (IQR 1-4) versus 1 (IQR 1-6) for FFI and MVL, respectively. The median visual analog scale score for patients' assessment of discomfort for both techniques was 2, FFI (IQR 0-3), MVL (IQR 0-4). Conclusions The authors found no difference in time to tracheal intubation between awake FFI and awake MVL intubation performed by experienced anesthesiologists in patients with anticipated difficult airway.

scholarly journals Comparison of GlideScope Videolaryngoscopy to Direct Laryngoscopy for Intubation of a Pediatric Simulator by Novice Physicians

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Joni E. Rabiner ◽  
Marc Auerbach ◽  
Jeffrey R. Avner ◽  
Dina Daswani ◽  
Hnin Khine
Keyword(s):  
Crossover Study ◽  
Difficult Airway ◽  
Direct Laryngoscopy ◽  
Successful Intubation ◽  
Success Rates ◽  
Normal Airway ◽  
Intubation Success ◽  
Mean Time ◽  
Randomized Crossover Study

Objective. To compare novice clinicians’ performance using GlideScope videolaryngoscopy (GVL) to direct laryngoscopy (DL).Methods. This was a prospective, randomized crossover study. Incoming pediatric interns intubated pediatric simulators in four normal and difficult airway scenarios with GVL and DL. Primary outcomes included time to intubation and rate of successful intubation. Interns rated their satisfaction of the devices and chose the preferred device.Results. Twenty-five interns were included. In the normal airway scenario, there were no differences in mean time for intubation with GVL or DL (61.4 versus 67.4 seconds, ) or number of successful intubations (19 versus 18, ). In the difficult airway scenario, interns took longer to intubate with GVL than DL (87.7 versus 61.3 seconds, ), but there were no differences in successful intubations (14 versus 15, ). There was a trend towards higher satisfaction for GVL than DL (7.3 versus 6.4, ), and GVL was chosen as the preferred device by a majority of interns (17/25, 68%).Conclusions. For novice clinicians, GVL does not improve time to intubation or intubation success rates in a pediatric simulator model of normal and difficult airway scenarios. Still, these novice clinicians overall preferred GVL.

scholarly journals Proficiencies of Military Medical Officers in Intubating Difficult Airways

2020 ◽  
Author(s):  
Jonathan Zhao Min Lim ◽  
Shi Hao Chew ◽  
Benjamin Zhao Bin Chin ◽  
Raymond Chern Hwee Siew
Keyword(s):  
Difficult Airway ◽  
Success Rate ◽  
Graduate Training ◽  
Success Rates ◽  
Post Graduate ◽  
Airway Trauma ◽  
Intubation Success ◽  
Post Graduate Training ◽  
Difficult Airways ◽  
Mean Time

Abstract Background This study sheds light on the proficiency of military medical officers who had received between 2-3 years of post-graduate training, in the handling of the difficult airway in a trauma manikin simulator using direct and video laryngoscopes. Method 133 doctors from the Singapore Armed Forces Medical Officer Cadet Course were assessed using high-fidelity simulator models with standardised difficult airways (simulator with tongue-swelling and cervical collar). They used the Macintosh direct laryngoscope (DL), King Vision channelled-blade laryngoscope (KVC), King Vision non-channelled blade laryngoscope (KVNC), and the McGrath (MG) laryngoscope on the same model in a randomised sequence. The intubation success rates and time to intubation were recorded and analysed for the study. Results The medical officers had a 71.4% intubation success rate with the DL on the difficult airway trauma simulator model and the mean time to intubation of 40.1s. With the KVC, the success rate is 86.5% with mean intubation time of 40.4s. The KVNC produced 24.8% success rate, with mean time to intubation of 53.2s. The MG laryngoscope produced 85.0% success rate, with a mean time of intubation of 37.4s. Conclusion Military medical officers with 2-3 years of post-graduate training had a success rate of 71.4% success rate intubating a simulated difficult airway in a trauma setting using a DL. Success rates were improved with the use of KVC and the MG laryngoscope, but was worse with the KVNC.

Difficult Airway Simulator Intubation Success Rates Using Commission on Accreditation of Medical Transport Systems Training Standards

2011 ◽  
Vol 30 (4) ◽  
pp. 208-215 ◽  
Author(s):  
Frank Thomas ◽  
Carol Rhoades ◽  
Judi Carpenter ◽  
Renee Holleran ◽  
Diana Handrahan
Keyword(s):  
Difficult Airway ◽  
Transport Systems ◽  
Success Rates ◽  
Intubation Success ◽  
Training Standards ◽  
Medical Transport

scholarly journals Proficiencies of Military Medical Officers in Intubating Difficult Airways

2020 ◽  
Author(s):  
Jonathan Zhao Min Lim ◽  
Shi Hao Chew ◽  
Benjamin Zhao Bin Chin ◽  
Raymond Chern Hwee Siew
Keyword(s):  
Difficult Airway ◽  
Success Rate ◽  
Graduate Training ◽  
Success Rates ◽  
Post Graduate ◽  
Airway Trauma ◽  
Intubation Success ◽  
Post Graduate Training ◽  
Difficult Airways ◽  
Mean Time

Abstract Background This study sheds light on the proficiency of military medical officers who had received between 2-3 years of post-graduate training, in the handling of the difficult airway in a trauma manikin simulator using direct and video laryngoscopes. Method 133 doctors from the Singapore Armed Forces Medical Officer Cadet Course were assessed using high-fidelity simulator models with standardised difficult airways (simulator with tongue-swelling and cervical collar). They used the Macintosh direct laryngoscope (DL), King Vision channelled-blade laryngoscope (KVC), King Vision non-channelled blade laryngoscope (KVNC), and the McGrath (MG) laryngoscope on the same model in a randomised sequence. The intubation success rates and time to intubation were recorded and analysed for the study. Results The medical officers had a 71.4% intubation success rate with the DL on the difficult airway trauma simulator model and the mean time to intubation of 40.1s. With the KVC, the success rate is 86.5% with mean intubation time of 40.4s. The KVNC produced 24.8% success rate, with mean time to intubation of 53.2s. The MG laryngoscope produced 85.0% success rate, with a mean time of intubation of 37.4s. Conclusion Military medical officers with 2-3 years of post-graduate training had a success rate of 71.4% success rate intubating a simulated difficult airway in a trauma setting using a DL. Success rates were improved with the use of KVC and the MG laryngoscope, but was worse with the KVNC.

scholarly journals Proficiencies of military medical officers in intubating difficult airways

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jonathan ZM Lim ◽  
Shi Hao Chew ◽  
Benjamin ZB Chin ◽  
Raymond CH Siew
Keyword(s):  
Difficult Airway ◽  
Success Rate ◽  
Graduate Training ◽  
Success Rates ◽  
Post Graduate ◽  
Airway Trauma ◽  
Intubation Success ◽  
Post Graduate Training ◽  
Difficult Airways ◽  
Mean Time

Abstract Background This study sheds light on the proficiency of military medical officers who had received between 2 and 3 years of post-graduate training, in the handling of the difficult airway in a trauma manikin simulator using direct and video laryngoscopes. Method One hundred thirty-three doctors from the Singapore Armed Forces Medical Officer Cadet Course were assessed using high-fidelity simulator models with standardised difficult airways (simulator with tongue-swelling and cervical collar). They used the Macintosh direct laryngoscope (DL), King Vision channelled-blade laryngoscope (KVC), King Vision non-channelled blade laryngoscope (KVNC), and the McGrath (MG) laryngoscope on the same model in a randomised sequence. The intubation success rates and time to intubation were recorded and analysed for the study. Results The medical officers had a 71.4% intubation success rate with the DL on the difficult airway trauma simulator model and the mean time to intubation of 40.1 s. With the KVC, the success rate is 86.5% with mean intubation time of 40.4 s. The KVNC produced 24.8% success rate, with mean time to intubation of 53.2 s. The MG laryngoscope produced 85.0% success rate, with a mean time of intubation of 37.4 s. Conclusion Military medical officers with 2–3 years of post-graduate training had a success rate of 71.4% success rate intubating a simulated difficult airway in a trauma setting using a DL. Success rates were improved with the use of KVC and the MG laryngoscope, but was worse with the KVNC.

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