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VieScope® laryngoscope versus Macintosh laryngoscope during difficult intubation performed by paramedics: a randomized cross-over manikin trial
, 42, 52, 62, 72
Affiliations- Maria Sklodowska-Curie Medical Academy in Warsaw, Warsaw, Poland
- Polish Society of Disaster Medicine, Warsaw, Poland
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
- Department of Nephrology Nursing, Medical University of Warsaw, Warsaw, Poland
- Chair of Emergency Medicine, Bialystok Medical University, Bialystok, Poland
- Chair and Department of Medical Education, Poznan University of Medical Sciences, Poznan, Poland
- Bialystok Oncology Center, Bialystok, Poland
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Abstract
INTRODUCTION: The aim of this study was to evaluate intubation performance by paramedics using Macintosh
laryngoscope and VieScope® laryngoscope under simulated difficult airway conditions.
METHODS: In a randomized, single-blinded, cross-over simulation trial, 42 paramedics performed endotracheal
intubation using VieScope® and Macintosh (MAC) laryngoscopes in two difficult airway scenarios: (A)
tongue edema, (B) manual cervical inline stabilization. The order of participants and intubation methods was
random. Time to ventilation constituted the primary outcome, and the secondary outcomes were the success
rate of first intubation attempt, overall intubation success rate, Cormack and Lehane grade, and ease of use.
RESULTS: In scenario A, the median overall intubation time was 55s (46–109) in the MAC group and 30.5s
(26–35) in the VieScope® group (p < 0.001). The efficacy of the first intubation attempt with MAC and Vie-
Scope® varied and amounted to 64.3% vs. 95.2% (p < 0.001). During scenario B, VieScope® offered better
intubation conditions than MAC (p < 0.001), including shorter intubation time, higher first attempt and
overall intubation success rates, as well as better glottic view.
CONCLUSIONS: In this simulation trial, we found that VieScope® could be successfully used for intubation in
difficult airways by paramedics with little simulation experience with this device. VieScope® was associated
with shorter time and higher success rates of intubation attempt compared with MAC. Nevertheless, we
recommend that the performance of VieScope® and MAC should be further evaluated in the clinical setting
to confirm our results.
Abstract
INTRODUCTION: The aim of this study was to evaluate intubation performance by paramedics using Macintosh
laryngoscope and VieScope® laryngoscope under simulated difficult airway conditions.
METHODS: In a randomized, single-blinded, cross-over simulation trial, 42 paramedics performed endotracheal
intubation using VieScope® and Macintosh (MAC) laryngoscopes in two difficult airway scenarios: (A)
tongue edema, (B) manual cervical inline stabilization. The order of participants and intubation methods was
random. Time to ventilation constituted the primary outcome, and the secondary outcomes were the success
rate of first intubation attempt, overall intubation success rate, Cormack and Lehane grade, and ease of use.
RESULTS: In scenario A, the median overall intubation time was 55s (46–109) in the MAC group and 30.5s
(26–35) in the VieScope® group (p < 0.001). The efficacy of the first intubation attempt with MAC and Vie-
Scope® varied and amounted to 64.3% vs. 95.2% (p < 0.001). During scenario B, VieScope® offered better
intubation conditions than MAC (p < 0.001), including shorter intubation time, higher first attempt and
overall intubation success rates, as well as better glottic view.
CONCLUSIONS: In this simulation trial, we found that VieScope® could be successfully used for intubation in
difficult airways by paramedics with little simulation experience with this device. VieScope® was associated
with shorter time and higher success rates of intubation attempt compared with MAC. Nevertheless, we
recommend that the performance of VieScope® and MAC should be further evaluated in the clinical setting
to confirm our results.
Keywords
endotracheal intubation, difficult airway, VieScope® laryngoscope, channeled laryngoscope, medical simulation, paramedic
About this articleTitle
VieScope® laryngoscope versus Macintosh laryngoscope during difficult intubation performed by paramedics: a randomized cross-over manikin trial
Journal
Disaster and Emergency Medicine Journal
Issue
Article type
Research paper
Pages
134-141
Published online
2020-09-16
Page views
880
Article views/downloads
760
DOI
Bibliographic record
Disaster Emerg Med J 2020;5(3):134-141.
Keywords
endotracheal intubation
difficult airway
VieScope® laryngoscope
channeled laryngoscope
medical simulation
paramedic
Authors
Maciej Maslanka
Jacek Smereka
Lukasz Czyzewski
Jerzy Ladny
Marek Dabrowski
Lukasz Szarpak
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