Vol 3, No 3 (2018)
Review paper
Published online: 2018-09-30

open access

Page views 2138
Article views/downloads 719
Get Citation

Connect on Social Media

Connect on Social Media

Use of video laryngoscopes by inexperienced personnel in difficult intubations

Maciej Sip1, Radoslaw Zalewski1, Tomasz Klosiewicz1, Bartosz Zawada1, Mateusz Szarek2, Zuzanna Popielarska2, Marek Dabrowski3
Disaster Emerg Med J 2018;3(3):96-100.

Abstract

The current gold standard in securing airway patency remains to be endotracheal intubation. It is the only method, which allows for nearly 100% protection of the bronchial tree from aspiration of gastric contents as well as providing the most ideal circumstances for control of ventilation parameters. Endotracheal intu- bation, although in many aspects superior to other methods of securing airways, can only be performed by skilled and experienced personnel in ideal conditions. An example of such conditions are in an operating room in the preoperative period when an anesthesiologist is able to proficiently perform the task with all of the tools and equipment needed at hand. However, in many situations, especially in emergencies, such ideal conditions are difficult or impossible to achieve. One of the many reasons behind this is often the lack of experienced personnel at the scene of an emergency. Another significant difficulty arises from trauma patients who must maintain an immobilized cervical spine, as well as those patients who are undergoing active cardiopulmonary resuscitation when providing high quality chest compressions is the highest priority. Therefore, it seems reasonable to look for the methods which on one hand will secure an airway with a tube inserted directly into the larynx, and on the other hand will make the procedure more accessible to less expe- rienced personnel by maintaining the proper patient safety throughout the whole procedure. A noteworthy method, which achieves this goal, is the use of the video laryngoscopes for endotracheal intubation. The participation in a short introductory training, regarding the use of the device itself, is sufficient to allow for the efficient intubation. The parameters which can be used to compare these different intubation methods include the ease of use, the rate of effectiveness of the first intubation trial as well as the total time needed for the procedure. The authors of this article attempt to compare classic laryngoscopes to video-assisted laryngoscopes. 

Article available in PDF format

View PDF Download PDF file

References

  1. Ladny JR, Sierzantowicz R, Kedziora J, et al. Comparison of direct and optical laryngoscopy during simulated cardiopulmonary resuscitation. Am J Emerg Med. 2017; 35(3): 518–519.
  2. Sip M, Dabrowska A, Prucnal K, et al. Supraglottic devices — future or everyday life? . Disaster Emerg Med J. 2017; 2(2): 74–83.
  3. Soar J, Nolan JP, Böttiger BW, et al. Adult advanced life support section Collaborators. European Resuscitation Council Guidelines for Resuscitation 2015: Section 3. Adult advanced life support. Resuscitation. 2015; 95: 100–147.
  4. Madziała M. The ETView tracheoscopic ventilation tube for trauma patient intubation. Disaster and Emergency Medicine Journal. 2018; 3(2): 69–70.
  5. von Rüden C, Bühren V, Perl M. Polytrauma Management — Treatment of Severely Injured Patients in ER and OR. Z Orthop Unfall. 2017; 155(5): 603–622.
  6. Adnet F, Racine SX, Borron SW, et al. A survey of tracheal intubation difficulty in the operating room: a prospective observational study. Acta Anaesthesiol Scand. 2001; 45(3): 327–332.
  7. Ladny JR, Smereka J, Szarpak L. Comparison of the Trachway video intubating stylet and Macintosh laryngoscope for endotracheal intubation. Preliminary data. Am J Emerg Med. 2017; 35(4): 574–575.
  8. Gaither JB, Spaite DW, Stolz U, et al. Prevalence of difficult airway predictors in cases of failed prehospital endotracheal intubation. J Emerg Med. 2014; 47(3): 294–300.
  9. Satyadas T, Nasir N, Erel E, et al. Iatrogenic tracheal rupture: a novel approach to repair and a review of the literature. J Trauma. 2003; 54(2): 369–371.
  10. Kurowski A, Szarpak Ł, Zaśko P, et al. Comparison of direct intubation and Supraglottic Airway Laryngopharyngeal Tube (S.A.L.T.) for endotracheal intubation during cardiopulmonary resuscitation. Randomized manikin study. Anaesthesiol Intensive Ther. 2015; 47(3): 195–199.
  11. Cobas MA, De la Peña MA, Manning R, et al. Prehospital intubations and mortality: a level 1 trauma center perspective. Anesth Analg. 2009; 109(2): 489–493.
  12. Mort TC. Emergency tracheal intubation: complications associated with repeated laryngoscopic attempts. Anesth Analg. 2004; 99(2): 607–13, table of contents.
  13. Gawel W, Kaminska H, Wieczorek W. Uescope as a method of endotracheal intubation of trauma patient. Disaster Emerg Med. 2017; 2(4): 175–176.
  14. Nouruzi-Sedeh P, Schumann M, Groeben H. Laryngoscopy via Macintosh Blade versus GlideScope. Anesthesiology. 2009; 110(1): 32–37.
  15. Wojewodzka-Zelezniakowicz M, Madziala A, Madziala M. Comparison of the Miller and Macintosh laryngoscopes in simulated pediatric trauma patient: a pilot study. Disaster Emerg Med J . 2017; 2(1): 1–6.
  16. Klosiewicz T, Sip M, Zalewski R, et al. Alternative to endotracheal intubation for paramedicss in order to provide direct laryngoskopy. A randomized manikin trial. Disaster Emerg Med J. 2017; 2(3): 142–144.
  17. Shravanalakshmi D, Bidkar PU, Narmadalakshmi K, et al. Comparison of intubation success and glottic visualization using King Vision and C-MAC videolaryngoscopes in patients with cervical spine injuries with cervical immobilization: A randomized clinical trial. Surg Neurol Int. 2017; 8: 19.
  18. Kleine-Brueggeney M, Buttenberg M, Greif R, et al. Evaluation of three unchannelled videolaryngoscopes and the Macintosh laryngoscope in patients with a simulated difficult airway: a randomised, controlled trial. Anaesthesia. 2017; 72(3): 370–378.
  19. Smereka J, Ladny JR, Naylor A, et al. C-MAC compared with direct laryngoscopy for intubation in patients with cervical spine immobilization: A manikin trial. Am J Emerg Med. 2017; 35(8): 1142–1146.
  20. Smereka J, Czyzewski L, Szarpak L, et al. Comparison between the TrueView EVO2 PCD and direct laryngoscopy for endotracheal intubation performed by paramedics: Preliminary data. Am J Emerg Med. 2017; 35(5): 789–790.
  21. Sierzantowicz R, Dabrowska A, Dabrowski M, et al. ETView® video-tube versus Intubrite® laryngoscope for endotracheal intubation during CPR. Am J Emerg Med. 2017; 35(9): 1367–1368.
  22. Wolf LE, Aguirre JA, Vogt C, et al. Transfer of skills and comparison of performance between king vision® video laryngoscope and macintosh blade following an AHA airway management course. BMC Anesthesiol. 2017; 17(1): 5.
  23. Alvis BD, Hester D, Watson D, et al. Randomized controlled trial comparing the McGrath MAC video laryngoscope with the King Vision video laryngoscope in adult patients. Minerva Anestesiol. 2016; 82(1): 30–35.
  24. Eismann H, Sieg L, Etti N, et al. Improved success rates using videolaryngoscopy in unexperienced users: a randomized crossover study in airway manikins. Eur J Med Res. 2017; 22(1): 27.
  25. 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.
  26. Ndoko SK, Amathieu R, Tual L, et al. Tracheal intubation of morbidly obese patients: a randomized trial comparing performance of Macintosh and Airtraq laryngoscopes. Br J Anaesth. 2008; 100(2): 263–268.
  27. Gaszynski T. TotalTrack video intubating laryngeal mask in super-obese patients - series of cases. Ther Clin Risk Manag. 2016; 12: 335–338.



Disaster and Emergency Medicine Journal