scholarly journals Comparison of VividTrac®, King Vision® and Macintosh laryngoscopy for normal and difficult airways during simulated cardiopulmonary resuscitation among novices

2021 ◽  
Author(s):  
Dóra Keresztes ◽  
Ákos Mérei ◽  
Martin Rozanovic ◽  
Edina Nagy ◽  
Zoltán Kovács-Ábrahám ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Difficult Airway ◽  
Endotracheal Intubation ◽  
User Satisfaction ◽  
Macintosh Laryngoscope ◽  
Dental Trauma ◽  
Esophageal Intubation ◽  
Success Rates ◽  
Normal Airway ◽  
Novice Users

Abstract Background: Successful early endotracheal intubation improves neurological outcomes in cardiopulmonary resuscitation. However, endotracheal intubation should not compromise cardiopulmonary resuscitation effectiveness and thus requires experience. The use of videolaryngoscopes might decrease the number of attempts as well as the time needed for intubation, especially among novice users. We sought to compare videolaryngoscopes with direct laryngoscopy in simulated cardiopulmonary resuscitation scenarios in mannequins by novices.Methods: Forty-four medical students were recruited to serve as novice users. Following brief, standardized training, students were asked to execute endotracheal intubation with each of the devices, including the King Vision®, the Macintosh laryngoscope and the VividTrac®, on acardiopulmonary resuscitation trainer (Ambu Man Advanced®) in normal and difficult airway scenarios. We evaluated the time to and the proportion of successful intubation, the best view of the glottis, esophageal intubation, dental trauma and user satisfaction.Results: In the normal airway scenario, significantly shorter intubation times (P < 0.05) were measured by King Vision®than by Macintosh laryngoscope. However, VividTrac® was proven to be similar (P > 0.05) to Macintosh laryngoscope in this regard in the normal airway scenario. In the difficult airway scenarios, we found VividTrac® superior (P < 0.05) to King Vision® and Macintosh laryngoscope regarding laryngoscopy times, but there were no significant differences between devices in intubation times. In both normal and difficult airway cardiopulmonary resuscitation scenarios, we noted no difference (P > 0.05) in first attempt success rates, the best view of the glottis and dental trauma, but esophageal intubation and the use of bougie were more frequent (P < 0.05) withMacintosh laryngoscopethan with videolaryngoscopes. The shortest tube insertion times were related to King Vision® in both scenarios.Conclusion: Based upon our results, King Vision®was superior to Macintosh laryngoscoperegarding intubation time in the normal airway cardiopulmonary resuscitation scenario for novice users. We noted significantly less esophageal intubationwhen using videolaryngoscopes compared to Macintosh laryngoscope in both scenarios; thus,videolaryngoscopes might be recommended for novice users for both cardiopulmonary resuscitation scenarios.

scholarly journals Comparison of VividTrac, King Vision and Macintosh laryngoscopes in normal and difficult airways during simulated cardiopulmonary resuscitation among novices

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260140
Author(s):  
Dóra Keresztes ◽  
Ákos Mérei ◽  
Martin Rozanovic ◽  
Edina Nagy ◽  
Zoltán Kovács-Ábrahám ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Difficult Airway ◽  
Success Rate ◽  
Endotracheal Intubation ◽  
Macintosh Laryngoscope ◽  
Dental Trauma ◽  
Esophageal Intubation ◽  
Successful Intubation ◽  
Normal Airway ◽  
Novice Users

Introduction Early endotracheal intubation improves neurological outcomes in cardiopulmonary resuscitation, although cardiopulmonary resuscitation is initially carried out by personnel with limited experience in a significant proportion of cases. Videolaryngoscopes might decrease the number of attempts and time needed, especially among novices. We sought to compare videolaryngoscopes with direct laryngoscopes in simulated cardiopulmonary resuscitation scenarios. Materials and methods Forty-four medical students were recruited to serve as novice users. Following brief, standardized training, students executed endotracheal intubation with the King Vision®, Macintosh and VividTrac® laryngoscopes, on a cardiopulmonary resuscitation trainer in normal and difficult airway scenarios. We evaluated the time to and proportion of successful intubation, the best view of the glottis, esophageal intubation, dental trauma and user satisfaction. Results In the normal airway scenario, significantly shorter intubation times were achieved using the King Vision® than the Macintosh laryngoscope. In the difficult airway scenario, we found that the VividTrac® was superior to the King Vision® and Macintosh laryngoscopes in the laryngoscopy time. In both scenarios, we noted no difference in the first-attempt success rate, but the best view of the glottis and dental trauma, esophageal intubation and bougie use were more frequent with the Macintosh laryngoscope than with the videolaryngoscopes. The shortest tube insertion times were achieved using the King Vision® in both scenarios. Conclusion All providers achieved successful intubation within three attempts, but we found no device superior in any of our scenarios regarding the first-attempt success rate. The King Vision® was superior to the Macintosh laryngoscope in the intubation time in the normal airway scenario and noninferior in the difficult airway scenario for novice users. We noted significantly less esophageal intubation using the videolaryngoscopes than using the Macintosh laryngoscope in both scenarios. Based on our results, the KingVision® might be recommended over the VividTrac® and Macintosh laryngoscopes for further evaluation.

scholarly journals Endotracheal intubation in a ramped versus supine position in the emergency department: A randomised crossover manikin study

2020 ◽  
pp. 102490792094163
Author(s):  
Carolyn Cheuk Lam Hung ◽  
Anthony Wong
Keyword(s):  
Emergency Department ◽  
Difficult Airway ◽  
Endotracheal Intubation ◽  
Supine Position ◽  
Success Rates ◽  
Normal Airway ◽  
Glottic View ◽  
Accident And Emergency ◽  
Significant Difference ◽  
Accident And Emergency Department

Background: Performing endotracheal intubation by placing patients in a ramped position has been shown to improve the ease of intubation and to reduce complications. The above findings, however, were only established in the operation theatre and intensive care settings. Objective: In order to establish the findings in the setting of the emergency department, we attempt to compare the ramped versus supine positions in normal and difficult airway scenarios. Methods: Medical doctors practicing at a local Accident and Emergency Department were recruited into a crossover randomised study. They were asked to perform intubations on a manikin in four scenarios. The manikin was put in a ramp or supine position. In addition, the manikin settings were adjusted to normal and difficult airways. Results: A total of 39 Accident and Emergency Department doctors were recruited. There was no statistically significant difference in the first-attempt success rates using the ramped position compared to supine position in either airway scenario (100% vs. 97.4%, P = 1 in normal airway, 79.5% vs. 74.4%, P = 0.789 in difficult airway). The mean intubation time in difficult airway setting was shorter when the manikin was put into ramped position (28.3 s vs. 38.4 s, P = 0.134). The ramped position improved the glottic view in the difficult airway setting ( P = 0.017). More intubators preferred to place the manikin into a ramped position during difficult airway setting (67%, P = 0.007). Experienced male intubators performed better in normal airway scenarios, whereas Accident and Emergency Department fellows performed better in difficult airway scenarios. Conclusion: The ramped position improves glottic view and operator ease when intubating a simulated 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 A comparison of the force applied on oral structures during intubation attempts between the Pentax-AWS airwayscope and the Macintosh laryngoscope: a high-fidelity simulator-based study

BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e006416 ◽  
Author(s):  
Tadahiro Goto ◽  
Yasuaki Koyama ◽  
Takashiro Kondo ◽  
Yusuke Tsugawa ◽  
Kohei Hasegawa
Keyword(s):  
Emergency Medicine ◽  
Difficult Airway ◽  
Macintosh Laryngoscope ◽  
Maximum Force ◽  
High Fidelity ◽  
Emergency Physicians ◽  
Direct Laryngoscope ◽  
Normal Airway ◽  
Glottic View ◽  
Maxillary Incisors

ObjectiveWe sought to determine whether the use of Pentax-AWS Airwayscope (AWS) applied less force on oral structures during intubation attempts than a conventional direct laryngoscope (DL).DesignProspective cross-over study.ParticipantsA total of 37 physicians (9 transitional-year residents, 20 emergency medicine residents and 8 emergency physicians) were enrolled.InterventionsWe used four simulation scenarios according to the difficulty of intubation and devices and used a high-fidelity simulator to quantify the forces applied on the oral structures.Outcome measuresPrimary outcomes were the maximum force applied on the maxillary incisors and tongue. Other outcomes of interest were time to intubation and glottic view during intubation attempts.ResultsThe maximum force applied on the maxillary incisors in the normal airway scenario was higher with the use of AWS than that with DL (107 newton (N) vs 77 N, p=0.02). By contrast, the force in the difficult airway scenario was significantly lower with the use of AWS than that of the DL (89 N vs 183 N, p<0.01). Likewise, the force applied on the tongue was significantly lower with the use of AWS than the use of DL in both airway scenarios (11 N vs 27 N, p<0.001 in the normal airway scenario; 12 N vs 40 N, p<0.01 in the difficult airway scenario).ConclusionsThe use of AWS during intubation attempts was associated with decreased forces applied to oral structures in the simulated difficult airway scenario.

scholarly journals Comparison of a New Video Intubation Stylet and McGrath® MAC Video Laryngoscope for Intubation in an Airway Manikin with Normal Airway and Cervical Spine Immobilization Scenarios by Novice Personnel: A Randomized Crossover Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Jin-Woo Park ◽  
Sungmin An ◽  
Seongjoo Park ◽  
Francis Sahngun Nahm ◽  
Sung-Hee Han ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Endotracheal Intubation ◽  
Odds Ratio ◽  
Video Laryngoscope ◽  
Intubation Time ◽  
Normal Airway ◽  
Intubation Stylet ◽  
Novice Users ◽  
Cervical Immobilization ◽  
Randomized Crossover Study

The use of both a video laryngoscope and a video intubation stylet, compared with the use of a direct laryngoscope, is not only easier to learn but also associated with a higher success rate in performing endotracheal intubation for novice users. However, data comparing the two video devices used by novice personnel are rarely found in literature. Nondelayed intubation is an important condition to determine the prognosis in critically ill patients; hence, exploring intubation performance in various situations is of clinical significance. This study is aimed at comparing a video stylet and a video laryngoscope for intubation in an airway manikin with normal airway and cervical spine immobilization scenarios by novice personnel. We compared the performance of intubation by novices between the Aram Video Stylet and the McGrath® MAC video laryngoscope in an airway manikin. Thirty medical doctors with minimal experience of endotracheal intubation attempted intubation on a manikin five times with each device in each setting (normal airway and cervical spine immobilization scenarios). The order of use of the devices in each scenario was randomized for each participant. In the normal airway scenario, the Aram stylet showed a significantly higher rate of successful intubation than the McGrath® (98.7% vs. 92.0%; odds ratio (95% CI): 6.4 (1.4–29.3); p = 0.006 ). The intubation time was shorter using the Aram Stylet than that using the McGrath® video laryngoscope ( p < 0.001 ). In the cervical immobilization scenario, successful endotracheal intubation was also more frequent using the Aram stylet than with the McGrath® (96.0% vs. 87.3%; odds ratio (95% CI): 3.5 (1.3–9.0); p = 0.007 ). The Aram Stylet intubation time was shorter ( p < 0.001 ). In novice personnel, endotracheal intubation appears to be more successful and faster using the Aram Video Stylet than the McGrath® MAC video laryngoscope.

scholarly journals Systematic Review Comparison of Endotracheal Intubation Success Rate Using McGrath® Mac Videolaryngoscope with Direct Laryngoscope (Macintosh): A Manikin Studies

2021 ◽  
Vol 3 (1) ◽  
pp. 22
Author(s):  
Dicha Niswansyah Auliyah ◽  
Prananda Surya Airlangga ◽  
Lilik Herawati
Keyword(s):  
Systematic Review ◽  
Difficult Airway ◽  
Success Rate ◽  
Endotracheal Intubation ◽  
Medical Personnel ◽  
Learning Material ◽  
Screening Process ◽  
Direct Laryngoscope ◽  
Normal Airway ◽  
Intubation Success Rate

Introduction: McGrath® MAC videolaryngoscope is a single-handed device designed to facilitate intubation in patients both in patients with normal airway conditions (without any complications) or airway conditions with complications such as cervical spine and/or anatomic abnormalities. Objective: This study aims to compare McGrath® MAC videolaryngoscope and direct laryngoscope using Macintosh blades as learning material or study simulators for medical personnel (including anesthesiologist and paramedics) and novice operator (medical students). Method: this study is a systematic review using the PRISMA method which was carried out systematically. Data was collected through Pubmed, direct science, EBSCOHost, and Proquest using the keywords ‘airway management ', ‘laryngoscopy', and 'manikin'. Journal included based on published publication time between 2008 and 2020, a study using SimMan Laerdal Airway manikin, a journal discussing intubation using McGrath® MAC videolaryngoscope and direct laryngoscope with Macintosh blades here, where it is normal airway (without complications) and difficult airway. Results: 1556 journals were collected through 4 journal search sites and then carried out a screening process for the publication year approved in 2008 to 2020. Four studies use adult manikin SimMan Laerdal Airway including 247 participants were included in this systematic review. Conclusion: Based on journals that have been reviewed, McGrath® MAC videolaryngoscope provides better and superior results compared to Macintosh in terms of the success rate and visualization of glottis. Also, the intubation time using McGrath® MAC videolaryngoscope is shorten compared to Macintosh both on the normal airway (without complication) and difficult airway. The participants (medical personnel and novice operators) in all studies that reviewed prefer to use McGrath® Mac videolaryngoscope instead of using direct laryngoscope with Macintosh blade for Endotracheal Intubation mainly used for learning or study simulators.

GlideScope® versus C-MAC®(D) videolaryngoscope versus Macintosh laryngoscope for double lumen endotracheal intubation in patients with predicted normal airways: a randomized, controlled, prospective trial

2020 ◽  
Author(s):  
Ping Huang ◽  
Renlong Zhou ◽  
Zhixing Lu ◽  
Yannan Hang ◽  
Shanjuan Wang ◽  
...  
Keyword(s):  
Endotracheal Intubation ◽  
Rating Scales ◽  
Macintosh Laryngoscope ◽  
Prospective Trial ◽  
Success Rates ◽  
Hemodynamic Changes ◽  
Double Lumen ◽  
Randomized Controlled ◽  
First Choice ◽  
Thoracic Anesthesia

Abstract Background The double lumen endotracheal tube (DLT) is the most widely-used device for single lung ventilation in current thoracic anesthesia practice. In recent years, the routine application of the videolaryngoscope for single lumen endotracheal intubation has increased; nevertheless there are few studies of the use of the videolaryngoscope for DLT. We wondered whether there were benefits to using the videolaryngoscope for DLT placement in patients with predicted normal airways. Therefore, this study was designed to compare the performances of the GlideScope ® , the C-MAC ® (D) videolaryngoscope and the Macintosh laryngoscope in DLT intubation. Methods This was a randomized, controlled, prospective study. We randomly allocated 90 adult patients with predicted normal airways into three groups. All patients underwent routine anesthesia using different laryngoscopes according to group allocation. We compared DLT insertion times, first-pass success rates, numerical rating scales (NRS) of DLT delivery and DLT insertion, Cormack-Lehane degrees (C/L), hemodynamic changes and incidences of intubation complications. All outcomes were analyzed using SPSS13.0. Results Compared with the GlideScope, the Macintosh gave shorter times for DLT insertion (median: 96 (IQR: 51 [min–max: 62–376] s vs 73 (26 [48–419] s, p = 0.003); however, there was no difference between the Macintosh and C-MAC(D) (p = 0.610). The Macintosh had a significantly higher successful first attempt rate than did the GlideScope or C-MAC(D) (p = 0.001, p = 0.028, respectively). NRS of DLT delivery and insertion were significantly lower in the Macintosh than in the others (p <0.001). However, the C/L degree in the Macintosh was significantly higher than in the others (p <0.001). The incidences of oral bleeding, hoarseness, sore throat and dental trauma were low in all groups (p >0.05). There were no significant differences in DLT misplacement, fiberoptic time or hemodynamic changes among the groups. Conclusions Compared with the Macintosh laryngoscope, the GlideScope ® and C-MAC ® (D) videolaryngoscopes may not be recommended as the first choice for routine DLT intubation in patients with predicted normal airways.

scholarly journals Video Laryngoscopic Endotracheal Intubation in Cardiac Operation Theater - Experience at a Peripheral Tertiary Healthcare Centre of Bangladesh

2020 ◽  
Vol 35 (1) ◽  
pp. 47-53
Author(s):  
Minhazur Rahman Chowdhury ◽  
Muhammad Abdul Quaium Chowdhury ◽  
Jitu Das Gupta ◽  
Subir Barua ◽  
Mohammad Abdul Mannan ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Endotracheal Intubation ◽  
Macintosh Laryngoscope ◽  
Hemodynamic Response ◽  
Video Laryngoscope ◽  
Adult Patients ◽  
Video Laryngoscopy ◽  
Intubation Time ◽  
Success Rates ◽  
Glottic View

Background: Endotracheal intubation is an essential primary skill for all anesthesiologists. For cardiac anesthesiologists rapid and proper intubation is more important as failure may cause serious consequences. Video laryngoscope provides a better real time view of the larynx, epiglottis and vocal cords. It also keeps the intubating anesthetist away from the patient as compared to conventional laryngoscopy. This may be very important in this COVID-19 era. To the best of our knowledge the Department of Cardiac Surgery and Cardiac Anesthesia of Chattogram Medical College & Hospital is the first center in Bangladesh to introduce video laryngoscope in cardiac OT. The objective of this study was aimed to compare the intubation time, hemodynamic response to laryngoscopy, success rates and operator’s comfort using the conventional Macintosh laryngoscope and video laryngoscope in adult patients undergoing cardiac surgery. Materials and Methods: A total of 60 adult patients were included in this comparative study, subjected to general anesthesia for cardiac surgery, intubated using either conventional Macintosh direct laryngoscope or video laryngoscope. Patients were intubated by 3 different consultant anesthesiologists with equal competency of our department. Results: There was not much difference between Video laryngoscopy and conventional laryngoscopy in terms of intubation time and success rate. Video laryngoscopy exhibited less hemodynamic response to laryngoscopy and intubation; however, the difference was not statistically significant in this small group of patients. Operators were much more comfortable with Video laryngoscope than conventional laryngoscope particularly with the cases of difficult intubation because of the better glottic view with the former. Conclusion: Video laryngoscope is preferred by cardiac anesthetists because of better glottic view. Bangladesh Heart Journal 2020; 35(1) : 47-53

scholarly journals Comparison of Different Intubation Methods in Difficult Airways during Simulated Cardiopulmonary Resuscitation with Continuous Chest Compression: A Randomized Cross-Over Manikin Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Togay Evrin ◽  
Jacek Smereka ◽  
Damian Gorczyca ◽  
Szymon Bialka ◽  
Jerzy Robert Ladny ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Airway Management ◽  
Success Rate ◽  
Endotracheal Intubation ◽  
Chest Compression ◽  
Macintosh Laryngoscope ◽  
Intubation Time ◽  
Intubation Success ◽  
Intubation Success Rate ◽  
Difficult Airways

Introduction. Airway management is one of key elements of resuscitation. Endotracheal intubation is still considered the gold standard for airway management during resuscitation. Aim. The aim of the study was to compare success rates and intubation time of different endotracheal intubation methods during emergency intubation with difficult airways in the conditions of cardiopulmonary resuscitation in a standardized manikin model. Methods. The study was designed as a prospective, randomized, cross-over simulation study. It involved 46 paramedics with at least 5 years of experience in Emergency Medical Service. The participants performed endotracheal intubation under difficult airway conditions during continuous chest compression, implemented with the LUCAS3 chest compression system. Three methods of tracheal intubation were applied: (1) standard Macintosh laryngoscope without a bougie stylet; (2) standard laryngoscope and a standard bougie stylet; (3) standard laryngoscope and a new bougie stylet. Results. The overall intubation success rate was 100% in the standard bougie and new bougie groups and lower (86.9%) when no bougie stylet was used (P=0.028). The intubation success rate with the 1st attempt equalled 91.3% for the new bougie group, 73.9% for standard bougie, and only 23.9% in the no-bougie group. The median intubation time was shortest in the new bougie group, where it amounted to 29 s (interquartile range [IQR]: 25–38); the time equalled 38s (IQR:31–44.5) in the standard bougie group and 47.5s (IQR:36–58) in the no-bougie group. The ease of use was lowest in the no-bougie group (85, IQR:63–88), average in the standard bougie group (44, IQR:30–51), and highest in the new bougie stylet group (32, IQR:19–41). Conclusion. In this manikin-based study, paramedics were able to perform endotracheal intubation with higher efficacy and in a shorter time using the new bougie stylet as compared with the standard bougie stylet.

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