Vol 6, No 2 (2021)
Research paper
Published online: 2021-06-08

open access

Page views 807
Article views/downloads 534
Get Citation

Connect on Social Media

Connect on Social Media

USB-endoscope laryngoscope is as effective as video laryngoscope in difficult intubation

Bülent Güngörer1, Meliha Findik2, Afsin Emre Kayipmaz1
Disaster Emerg Med J 2021;6(2):75-79.


BACKGROUND: Video laryngoscopy (VL) has recently been put into clinical use to minimize the limitations of direct laryngoscopy and assist physicians interested in airway management. However, the high cost is the biggest constraint especially in countries with limited resources. To lower the cost, a custom-made VL obtained by attaching a USB-endoscope camera ($8.5) to the Macintosh laryngoscope (USB-L) can be used.   MATERIAL AND METHODS: All intubations were performed in a difficult intubation model. Intubations were carried out by two emergency physicians. A Glidescope as a VL and a custom-made USB-L were used. In addition to these devices, one bougie to facilitate the advancement of the tube was used. The total intubation time was evaluated.   RESULTS: Correct tube placement for both operators was 100% for both devices. A difference between the operators in the duration of intubations could not be found. Also, there is no difference in the duration of intubations between the devices for both operators.   CONCLUSION: It was concluded that the USB-L and VL are not statistically different in terms of intubation time in the difficult intubation model using bougie. For countries with limited resources, the low-cost USB-L has come to the forefront due to the high cost of VL and difficulty of access.

Article available in PDF format

View PDF Download PDF file


  1. Maslanka M, Smereka J, Czyzewski L, et al. VieScope® laryngoscope versus Macintosh laryngoscope during difficult intubation performed by paramedics: a randomized cross-over manikin trial. Disaster and Emergency Medicine Journal. 2020.
  2. Sip M, Zalewski R, Klosiewicz T, et al. Use of video laryngoscopes by inexperienced personnel in difficult intubations. Disaster and Emergency Medicine Journal. 2018; 3(3): 96–100.
  3. Zaouter C, Calderon J, Hemmerling TM. Videolaryngoscopy as a new standard of care. Br J Anaesth. 2015; 114(2): 181–183.
  4. Karippacheril JG, Umesh G, Nanda S. Assessment and confirmation of tracheal intubation when capnography fails: a novel use for an USB camera. J Clin Monit Comput. 2013; 27(5): 531–533.
  5. Trivedi JN. An economical model for mastering the art of intubation with different video laryngoscopes. Indian J Anaesth. 2014; 58(4): 394–396.
  6. Vadhanan P, Balakrishnan K, Tripaty DK. Evaluation of a low-cost videolaryngoscope – A randomized controlled pilot study. Anaesthesia, Pain Intensive Care. 2017; 21(4): 406–12.
  7. Hasija N, Kale S, Girdhar KK. Digitizing the direct laryngoscopy experience: the economic way!! Korean J Anesthesiol. 2018; 71(6): 486–487.
  8. Cook TM, El-Boghdadly K, McGuire B, et al. Consensus guidelines for managing the airway in patients with COVID-19: Guidelines from the Difficult Airway Society, the Association of Anaesthetists the Intensive Care Society, the Faculty of Intensive Care Medicine and the Royal College of Anaesthetists. Anaesthesia. 2020; 75(6): 785–799.
  9. Yao W, Wang T, Jiang B, et al. collaborators. Emergency tracheal intubation in 202 patients with COVID-19 in Wuhan, China: lessons learnt and international expert recommendations. Br J Anaesth. 2020; 125(1): e28–e37.
  10. Lai HY. Aerosol Box. Protects healthcare providers during endotracheal intubation. Available from: https://sites.google. com/view/aerosolbox/home (accessed 18 Feb. ; 2021.
  11. Canelli R, Connor CW, Gonzalez M, et al. Barrier Enclosure during Endotracheal Intubation. N Engl J Med. 2020; 382(20): 1957–1958.
  12. Cook TM, El‐Boghdadly K, McGuire B, et al. Consensus guidelines for managing the airway in patients with COVID ‐19. Anaesthesia. 2020; 75(6): 785–799.
  13. Kleine-Brueggeney M, Greif R, Schoettker P, et al. Evaluation of six videolaryngoscopes in 720 patients with a simulated difficult airway: a multicentre randomized controlled trial. Br J Anaesth. 2016; 116(5): 670–679.
  14. Asai T. Videolaryngoscopes: do they truly have roles in difficult airways? Anesthesiology. 2012; 116(3): 515–517.
  15. Asai T, Liu EH, Matsumoto S, et al. Use of the Pentax-AWS in 293 patients with difficult airways. Anesthesiology. 2009; 110(4): 898–904.
  16. Jungbauer A, Schumann M, Brunkhorst V, et al. Expected difficult tracheal intubation: a prospective comparison of direct laryngoscopy and video laryngoscopy in 200 patients. Br J Anaesth. 2009; 102(4): 546–550.
  17. Malik MA, Subramaniam R, Maharaj CH, et al. Randomized controlled trial of the Pentax AWS, Glidescope, and Macintosh laryngoscopes in predicted difficult intubation. Br J Anaesth. 2009; 103(5): 761–768.
  18. Enomoto Y, Asai T, Arai T, et al. Pentax-AWS, a new videolaryngoscope, is more effective than the Macintosh laryngoscope for tracheal intubation in patients with restricted neck movements: A randomized comparative study. Br J Anaesth. 2008; 100: 544–8.
  19. Rendeki S, Keresztes D, Woth G, et al. Comparison of VividTrac®, Airtraq®, King Vision®, Macintosh Laryngoscope and a Custom-Made Videolaryngoscope for difficult and normal airways in mannequins by novices. BMC Anesthesiol. 2017; 17(1): 68.
  20. LIU Hu, SHI Xy, CHEN W, et al. Comparison between HPHJ-A video laryngoscope and macintosh laryngoscope in clinical intubation. Academic Journal of Second Military Medical University. 2010; 30(10): 1073–1075.
  21. Narayan AK, Janardhan AL, Prakash A, et al. Low-cost teaching aid: A modification of Macintosh blade into a video laryngoscope for teaching laryngoscopy and intubation. J Anaesthesiol Clin Pharmacol. 2018; 34(4): 552–554.

Disaster and Emergency Medicine Journal