scholarly journals Efficacy of RAMA Mobile Video Laryngoscope (RAMA-mVL) Versus McGrath® for Tracheal Intubation in Manikin. A Randomized Study

2021 ◽  
Vol 44 (4) ◽  
Author(s):  
Panvilai Tangkulpanich ◽  
Natsinee Athinartrattanapong ◽  
Porawin Ussawapitanon ◽  
Phanorn Chalermdamrichai ◽  
Jarupol Tuangsirisup
Keyword(s):  
Success Rate ◽  
Randomized Study ◽  
Medical Personnel ◽  
Video Laryngoscope ◽  
Intubation Time ◽  
Blinded Study ◽  
Intubation Success Rate ◽  
The Mean ◽  
The Cost ◽  
Better Than

Background: Video laryngoscope (VL) has increased the success rate of intubation but the commercial VL is unaffordable for community hospitals. Therefore, Ramathibodi mobile VL (RAMA-mVL) was invented to close the gap and expected that it would be equivalent to the current device and lower price.Objective: To determine the effectiveness of intubation, compare by using RAMA-mVL and McGrath®Methods: The randomized, single-blinded study of the success intubation between RAMA-mVL and McGrath® was conducted in a manikin. Medical personnel with intubation experiences was included and trained before performing the procedure. The success rate for one best shot of intubation, time to intubation, satisfaction, and value between both VL were recorded and analyzedResults: A total of 208 persons entered the research, 104 in each group. The success rate for intubation by using both VL is 100%. The mean of time to intubation using RAMA-mVL was significantly less than that of McGrath®, which were 9.12 (±4.28) and 11.19 (±5.04) seconds, respectively (95% CI 0.001 - 0.9, P = .002). The satisfaction with innovation that is easy to build between RAMA-mVL and McGrath® was 4.88 (±0.32) and 4.23 (±0.96) points (95% CI 0.46 - 0.85, P < .001). Additionally, the cost of RAMA-mVL was cheaper than McGrath®.Conclusions: RAMA-mVL performed equivalent and even better than McGrath® compared by intubation success rate, mean intubation time, satisfaction, and cost-effectiveness.

scholarly journals McGrath Video Laryngoscope May Take a Longer Intubation Time Than Macintosh Laryngoscope

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Prerana N. Shah ◽  
Kaveri Das
Keyword(s):  
Randomized Study ◽  
Macintosh Laryngoscope ◽  
Total Duration ◽  
Video Laryngoscope ◽  
Intubation Time ◽  
Laryngoscopic View ◽  
Lehane Grade ◽  
Secondary Endpoints ◽  
Grade Ii ◽  
Grade Iii

Background. Video laryngoscopes provide better view and can improve ease of intubation compared with standard laryngoscopes. Methods. A prospective randomized study was done on 60 patients, 18 to 65 years old, comparing McGrath video laryngoscope and Macintosh laryngoscope. The aim was to compare the ease, efficacy, and usability of them during routine airway management. The primary endpoint was duration of intubation and the secondary endpoints were Cormack and Lehane grade of laryngoscopic view, number of intubation attempts, and incidence of complications. Results. There was an increase in total duration of intubation with McGrath video laryngoscope with 42.9 ± 19.5 seconds compared to Macintosh laryngoscope with 17.9 ± 4.6 seconds. In Macintosh group, 73.3% had grade I, 20% had grade II, and 6.7% had grade III Cormack Lehane view, while in McGrath group, 83.3% had grade I, 13.3% had grade II, and 3.3% had grade III. In McGrath group, 6 patients (20%) required more than 120 seconds to get intubated and only 73.3% were intubated in 1 attempt, while patients in Macintosh group had 100% successful intubation in 1 attempt. Pharyngeal trauma was seen with McGrath videolaryngoscopy. Conclusion. Duration of laryngoscopy, intubation, and total duration of intubation were significantly higher in McGrath group than in Macintosh group. McGrath group required a higher number of intubation attempts.

The Race for Online Reputation: Implications for Platforms, Firms, and Consumers

2021 ◽  
Author(s):  
Mingwen Yang ◽  
Zhiqiang (Eric) Zheng ◽  
Vijay Mookerjee
Keyword(s):  
Adverse Event ◽  
Marketing Mix ◽  
Digital Economy ◽  
The Other ◽  
The Mean ◽  
The Absolute ◽  
The Cost ◽  
Online Reputation ◽  
Better Than

Online reputation has become a key marketing-mix variable in the digital economy. Our study helps managers decide on the effort they should use to manage online reputation. We consider an online reputation race in which it is important not just to manage the absolute reputation, but also the relative rating. That is, to stay ahead, a firm should try to have ratings that are better than those of its competitors. Our findings are particularly significant for platform owners (such as Expedia or Yelp) to strategically grow their base of participating firms: growing the middle of the market (firms with average ratings) is the best option considering the goals of the platform and the other stakeholders, namely incumbents and consumers. For firms, we find that they should increase their effort when the mean market rating increases. Another key insight for firms is that, sometimes, adversity can come disguised as an opportunity. When an adverse event strikes the industry (such as a reduction in sales margin or an increase in the cost of effort), a firm’s profit can increase if it can manage this event better than its competitors.

scholarly journals Should the Glidescope video laryngoscope be used first line for all oral intubations or only in those with a difficult airway? A review of current literature

2018 ◽  
Vol 28 (12) ◽  
pp. 322-333 ◽  
Author(s):  
Terrie-Marie Russell ◽  
Anil Hormis ◽  
Keyword(s):  
Difficult Airway ◽  
Success Rate ◽  
Macintosh Laryngoscope ◽  
Review Literature ◽  
Video Laryngoscope ◽  
Intubation Time ◽  
First Line ◽  
Glottic View ◽  
Glidescope Video Laryngoscope ◽  
Difficult Airways

The purpose of this study was to review literature that looked into the efficacy of the Glidescope video laryngoscope versus the Macintosh laryngoscope in oral endotracheal intubations. We aimed to answer the question ‘Should the Glidescope video laryngoscope laryngoscopes be used as first line intubation aids or only in the difficult airway?’ A systematic search of electronic databases was made. The inclusion criteria included: Glidescope, video laryngoscope, and Macintosh laryngoscope in human studies. The study aimed to compare first attempt success rate, glottic view and intubation time in papers dating between 2009 and 2017. Eleven trials with a total of 7,919 patients with both difficult and normal airways were included. The trials showed an improvement in first attempt success rate and glottic view with the Glidescope video laryngoscope especially in those with difficult airways. Overall time to intubate showed no significant differences between the Glidescope video laryngoscope and the Macintosh laryngoscope although it was identified that with increased training and experience with the Glidescope video laryngoscope, intubation time was reduced. Glidescope video laryngoscopes show advantages over the Macintosh laryngoscopes in obtaining better glottic views in those with difficult airways. However its use is not supported in all routine intubations.

scholarly journals Comparison between use of single lightwand and video laryngoscope-guided lightwand for tracheal intubation in simulated cervical spine-immobilized patients: a single-blind randomized study

2019 ◽  
Vol 47 (11) ◽  
pp. 5632-5642
Author(s):  
Ha Yeon Kim ◽  
Eun Jung Kim ◽  
Hei Jin Yoon ◽  
Byungwoong Ko ◽  
Seung Yeon Choi ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Postoperative Complications ◽  
Tracheal Intubation ◽  
Success Rate ◽  
Randomized Study ◽  
Video Laryngoscope ◽  
Second Grade ◽  
Airway Complications ◽  
Mucosal Bleeding ◽  
Single Blind

Objective This study was performed to compare the use of a video laryngoscope-guided lightwand versus a single lightwand for tracheal intubation performed by non-experts in cervical spine-immobilized patients. Methods In total, 318 patients under general anesthesia were assigned either to the single lightwand group (Group L) or the video laryngoscope-guided lightwand group (Group VL) at a 1:1 ratio. First- or second-grade residents performed tracheal intubation with the assigned device after applying semi-hard fitted cervical collars to the patients. Outcomes, including the success rate and airway complications, were compared between the two groups. Results There were no significant differences in demographics or airway-related characteristics between the two groups. The success rate of intubation on the first attempt was significantly higher in Group VL than in Group L (90% vs. 64%, respectively). Postoperative complications, including oral mucosal bleeding, hoarseness, and sore throat scores at 1 and 24 hours after surgery, were significantly lower in Group VL than in Group L. Conclusions The use of a video laryngoscope-guided lightwand for tracheal intubation can be useful for non-experts who encounter difficult airway situations.

scholarly journals Comparison of Direct and Indirect Laryngoscopes in Vomitus and Hematemesis Settings: A Randomized Simulation Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Ryosuke Mihara ◽  
Nobuyasu Komasawa ◽  
Sayuri Matsunami ◽  
Toshiaki Minami
Keyword(s):  
Tracheal Intubation ◽  
Success Rate ◽  
Macintosh Laryngoscope ◽  
Intubation Time ◽  
Direct Laryngoscope ◽  
Mcgrath Mac ◽  
Significant Difference ◽  
Intubation Success ◽  
Intubation Success Rate

Background.Videolaryngoscopes may not be useful in the presence of hematemesis or vomitus. We compared the utility of the Macintosh laryngoscope (McL), which is a direct laryngoscope, with that of the Pentax-AWS Airwayscope (AWS) and McGRATH MAC (McGRATH), which are videolaryngoscopes, in simulated hematemesis and vomitus settings.Methods.Seventeen anesthesiologists with more than 1 year of experience performed tracheal intubation on an adult manikin using McL, AWS, and McGRATH under normal, hematemesis, and vomitus simulations.Results.In the normal setting, the intubation success rate was 100% for all three laryngoscopes. In the hematemesis settings, the intubation success rate differed significantly among the three laryngoscopes (P=0.021). In the vomitus settings, all participants succeeded in tracheal intubation with McL or McGRATH, while five failed in the AWS trial with significant difference (P=0.003). The intubation time did not significantly differ in normal settings, while it was significantly longer in the AWS trial compared to McL or McGRATH trial in the hematemesis or vomitus settings (P<0.001, compared to McL or McGRATH in both settings).Conclusion.The performance of McGRATH and McL can be superior to that of AWS for tracheal intubation in vomitus and hematemesis settings in adults.

scholarly journals Comparison of Video Laryngoscope and Macintosh Laryngoscope for Face-to-Face Intubation in Sitting Manikin Model With Limitation of Neck Motion by Unexperienced Personnel

2021 ◽  
Vol 44 (1) ◽  
pp. 21-28
Author(s):  
Phatthranit Phattharapornjaroen ◽  
Promphet Nuanprom ◽  
Prayoot Suk-um ◽  
Manina Thilarak ◽  
Chaiyaporn Yuksen
Keyword(s):  
Success Rate ◽  
Vocal Cord ◽  
Macintosh Laryngoscope ◽  
Video Laryngoscope ◽  
Trauma Patients ◽  
Intubation Time ◽  
Intubation Technique ◽  
Cervical Spine Injuries ◽  
Face To Face ◽  
Spine Injuries

Background: Trauma patients who entrapped in the accident vehicle are predispose to have cervical spine injuries and they needed to be intubated with face-to-face intubation technique using Macintosh laryngoscope. Nowadays, video laryngoscope has been introduced to improve the intubation technique. Objective: To compare the effectiveness of video laryngoscope and Macintosh laryngoscope for face-to-face intubation in sitting manikin model with limitation of neck motion. Methods: The study was performed in a randomized experimental study. Subjects were divided into 2 groups both did face-to-face intubation using video laryngoscope and Macintosh laryngoscope in a sitting manikin model with limitation of neck motion. The success rate of intubation, time to finish intubation, and vocal cord visualization were analyzed. Results: Of 41 subjects including 2nd and 3rd year paramedic students, 21 subjects went to video laryngoscope group, and 20 subjects went to Macintosh laryngoscopes group. The Macintosh laryngoscope intubation technique showed significantly better success rate compared to video laryngoscope (100% and 25%, P < .001). In addition, intubation time of Macintosh laryngoscope was significantly less than video laryngoscope (mean [SD], 27 [24.7] and 75 [66.3] seconds, P < .001). However, vocal cord visualization from both laryngoscope techniques showed no statistically significant (P = .08). Conclusions: Intubation training of Macintosh laryngoscope for in sitting model with neck motion limitation showed better success rate and less time than video laryngoscope, with the same vocal cord visualization.  

scholarly journals Why USB-endoscope laryngoscopy is as effective as video laryngoscopy

2020 ◽  
Vol 43 (2) ◽  
pp. E55-59
Author(s):  
Meliha Findik ◽  
Afsin E. Kayipmaz ◽  
Cemil Kavalci ◽  
Tugce Sencelikel Sencelikel ◽  
Murat Muratoglu ◽  
...  
Keyword(s):  
Direct Laryngoscopy ◽  
Low Cost ◽  
Video Laryngoscope ◽  
Video Laryngoscopy ◽  
Intubation Time ◽  
Direct Laryngoscope ◽  
Correct Placement ◽  
Custom Made ◽  
Significant Difference ◽  
The Cost

Purpose: To compare the efficacy of a low-cost custom-made universal serial bus (USB) endoscope laryngoscope for intubation with a direct laryngoscope and a high-cost video laryngoscope in a mannequin study. Methods: We used one intubation simulator model (mannequin) in our study. A USB endoscope was mounted to the direct laryngoscope as a custom-made USB endoscope laryngoscope (USB-L). We used a video laryngoscope (Glidescope®, Verathon, USA) and a direct laryngoscope (Macintosh) for comparison. Intubation time and the correct placement of the tube were measured. Intubations were performed by two operators and results were compared. Results: We found a statistically significant difference between the video and direct laryngoscope groups (p < 0.001), as well as between the USB-L and direct laryngoscope groups (p = 0.001) for Operator 1. For Operator 2, there was a statistically significant difference between the video laryngoscope group and the direct laryngoscope group (p = 0.022); however, we did not find a significant difference between the USB-L group and the direct laryngoscope group (p = 0.154). Furthermore, there were no significant differences between the USB-L and video laryngoscope groups for either operator (p=0.347 for Operator 1 and p>0.999 for Operator 2). Conclusion: Our study showed that USB endoscope laryngoscope provided similar intubation time to video laryngoscopy at a fraction of the cost; and both had superior times in comparison with direct laryngoscopy.

scholarly journals A manikin study comparing the performance of the GlideScope®, the Airtraq® and the C-MAC® in endotracheal intubation using suction-assisted laryngoscopy airway decontamination techniques in a simulated massive haematemesis scenario by emergency doctors

2020 ◽  
pp. 102490792095779
Author(s):  
Ching Hin Kevin Wong ◽  
Shing Ko ◽  
Oi Fung Wong ◽  
Hing Man Ma ◽  
Chau Hung Albert Lit ◽  
...  
Keyword(s):  
Endotracheal Intubation ◽  
Video Laryngoscope ◽  
Superior Performance ◽  
Intubation Time ◽  
Failed Intubation ◽  
Management Skills ◽  
Significant Difference ◽  
Massive Haematemesis ◽  
Emergency Doctors ◽  
Better Than

Background: The suction-assisted laryngoscopy and airway decontamination (SALAD) techniques (level 1, SALAD-1 and level 2, SALAD-2) are newly proposed airway management skills to facilitate endotracheal intubation in patients with massive haematemesis. A pilot study using GlideScope® demonstrated the superior performance of SALAD-1 technique in massive haematemesis simulation. Objectives: To compare the performance of three different video laryngoscopes (the GlideScope®, the Airtraq® and the C-MAC®) in endotracheal intubation using SALAD techniques by emergency doctors in a manikin simulating massive haematemesis. Methods: Forty-eight emergency doctors were recruited. The participants’ performance of endotracheal intubation using the GlideScope®, the Airtraq® and the C-MAC® with the conventional and the two SALAD techniques in a manikin simulating massive haematemesis was evaluated. The time for intubation, number of attempts, rate of failed intubation, amount of aspirated fluid and the subjective ease of different devices and techniques were compared. Results: The C-MAC® had shorter intubation time compared with GlideScope® when using conventional (mean intubation time: 28.48 vs 47.00 s, p = 0.018) and SALAD-1 technique (mean intubation time: 29.35 vs 43.25 s, p < 0.039). The intubation time of all three video laryngoscopes was similar in SALAD-2 technique. There was no significant difference in the number of attempts and failed intubation rate among different video laryngoscopes in using different techniques. Intubation with the C-MAC® resulted in the least mean amount of aspiration in all the conventional (35.63 mL), SALAD-1 (14.06 mL) and SALAD-2 (18.13 mL) techniques. However, the results were not significantly different from the GlideScope® and the Airtraq®. The C-MAC® was rated the most favourable video laryngoscope for the SALAD-1 technique (p < 0.001). There was no significant preference for different video laryngoscopes in using the SALAD-2 technique (p = 0.111). Conclusion: All the video laryngoscopes have similar intubation performance with the SALAD-1 and SALAD-2 techniques. The C-MAC® performed better than GlideScope® in terms of intubation time. The C-MAC® was the most favourable video laryngoscope for the SALAD-1 technique.

scholarly journals Utility of a Gum-Elastic Bougie for Difficult Airway Management in Infants: A Simulation-Based Crossover Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Nobuyasu Komasawa ◽  
Akira Hyoda ◽  
Sayuri Matsunami ◽  
Nozomi Majima ◽  
Toshiaki Minami
Keyword(s):  
Tracheal Intubation ◽  
Airway Management ◽  
Success Rate ◽  
Difficult Airway Management ◽  
Intubation Time ◽  
Simulation Based ◽  
Intubation Success ◽  
Intubation Success Rate ◽  
Crossover Analysis ◽  
Airway Model

Background.Direct laryngoscopy with the Miller laryngoscope (Mil) for infant tracheal intubation is often difficult to use even for skilled professionals. We performed a simulation trial evaluating the utility of a tracheal tube introducer (gum-elastic bougie (GEB)) in a simulated, difficult infant airway model. Methods.Fifteen anesthesiologists performed tracheal intubation on an infant manikin at three different degrees of difficulty (normal [Cormack-Lehane grades (Cormack) 1-2], cervical stabilization [Cormack 2-3], and anteflexion [Cormack 3-4]) with or without a GEB, intubation success rate, and intubation time.Results.In the normal and cervical stabilization trials, all intubation attempts were successful regardless of whether or not the GEB was used. In contrast, only one participant succeeded in tracheal intubation without the GEB in the anteflexion trial; the success rate significantly improved with the GEB (P=0.005). Intubation time did not significantly change under the normal trial with or without the GEB (without, 12.7 ± 3.8 seconds; with, 13.4 ± 3.6 seconds) but was significantly shorter in the cervical stabilization and anteflexion trials with the GEB.Conclusion.GEB use shortened the intubation time and improved the success rate of difficult infant tracheal intubation by anesthesiologists in simulations.

Macintosh laryngoscope, i-view™, and C-MAC® video laryngoscopes for tracheal intubation with an aerosol box: A randomized, crossover, manikin study

2020 ◽  
Author(s):  
Toshiyuki Nakanishi ◽  
Yoshiki Sento ◽  
Yuji Kamimura ◽  
Kazuya Sobue
Keyword(s):  
Intensive Care ◽  
Tracheal Intubation ◽  
Success Rate ◽  
Macintosh Laryngoscope ◽  
Video Laryngoscope ◽  
Interquartile Range ◽  
Intubation Time ◽  
Lehane Grade ◽  
Significant Difference ◽  
Difficulty Scale

Abstract Background: The aerosol box was designed to prevent cough droplets from spreading, but it can impede tracheal intubation. We tested the hypothesis that the C-MAC® video laryngoscope (C-MAC) with an external display is more useful than the i-view™ video laryngoscope (i-view) with an integrated display, or a Macintosh direct laryngoscope (Macintosh) for tracheal intubation with an aerosol box.Methods: This prospective, randomized, crossover simulation study was conducted at an operating room of the two hospitals (a university hospital and a tertiary teaching hospital). We recruited 37 medical personnel (36 anesthesiologists and 1 dental anesthesiologist) who were working in the fields of anesthesia and intensive care with > 2 years of dedicated anesthesia experience from five hospitals. We divided the participants into six groups to use the laryngoscope in a determined order. After the training using each laryngoscope without a box, the participants performed tracheal intubation thrice with each laryngoscope with at least two-hour intervals. The primary outcome was the intubation time. The secondary outcomes were the success rate, Cormack-Lehane grade, and subjective difficulty scale score (numeric rating scale 0–10, 0: no difficulty, 10: highest difficulty). We used the Friedman test and the Wilcoxon signed-rank test with Bonferroni adjustment. Data are shown as median [interquartile range].Results: Thirty-seven personnel (11 women and 26 men) with 12 [5–19] (median [interquartile range]) years of anesthesia and intensive care experience were enrolled. There was no significant difference in the intubation time: 30 [26–32] s for Macintosh, 29 [26–32] s for i-view, and 29 [25–31] s for C-MAC (P=0.247). The success rate was 95%–100% without significant difference (P=0.135). The i-view and C-MAC video laryngoscopes exhibited superior Cormack-Lehane grades and lower subjective difficulty scale scores than the Macintosh laryngoscope; however, there were no differences between the i-view and C-MAC video laryngoscopes.Conclusions: Rapid and highly successful tracheal intubation was possible with Macintosh laryngoscope, i-view, and C-MAC video laryngoscopes on a manikin with an aerosol box. Improved Cormack-Lehane grade and ease of procedure may support the use of video laryngoscopes.Trial registration: UMIN Clinical Trials Registry, identifier UMIN000040269.

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