Article Data

  • Views 193
  • Dowloads 3

Original Research

Open Access

A prospective randomized high fidelity simulation center based side-by-side comparison analyzing the success and ease 

of conventional versus new generation video laryngoscope technology by inexperienced laryngoscopists

  • THOMAS C. WASS1
  • ADAM K. JACOB2
  • SANDRA L. KOPP2
  • LAURENCE C. TORSHER2

1,Mayo Clinic

2,Department of Anesthesiology College of Medicine Mayo Clinic

DOI: 10.22514/SV62.102011.5 Vol.6,Issue 2,October 2011 pp.36-45

Published: 31 October 2011

*Corresponding Author(s): THOMAS C. WASS E-mail: wass.thomas@mayo.edu

Abstract

Introduction.  Indirect video laryngoscopes are altering the landscape of airway management. The primary aim of this prospec-tive randomized patient simulator analysis was to objectively compare video laryngoscopes to standard airway management techniques in novice users.

Methods. "First year medical students were exposed to high-fidelity simulated normal and difficult airway scenarios while using an array of indirect video laryngoscopes (e.g., the GlideScope, McGRATH or Pentax AWS-100) that were compared to Macin-tosh laryngoscope and fiberoptic bronchoscope (i.e., historic gold standards for normal and difficult airways, respectively)." Results. In the normal airway scenario, the best glottic view (both subjective and objective) was obtained with the video laryngoscopes and intubation success rates were highest with the video laryngoscopes (100% success rate for each device) and Macintosh (80%). In the difficult airway scenario, the best glottic view was achieved with all video laryngoscopes and the fiberoptic bronchoscope; however, tracheal intubation was best achieved with the video laryngoscopes (100% success rate for each device) whereas the success rate with the bronchoscope was only 36%.

Discussion. Our findings support the use of the GlideScope, McGRATH, or Macintosh laryngoscopes for novice users mana-ging a normal airway. When managing the difficult airway, there was no difference between any video or Macintosh laryngosco-pe in the time to successfully intubate the trachea. Over time, study participants demonstrated learned behavior as they became more facile with all devices. When comparing the video laryngoscopes, all three performed similarly overall and proved useful in the hands of novice users. Regardless of airway difficulty, the fiberoptic bronchoscope yielded the worst results.

Keywords

airway, airway manage-ment, airway equipment, patient simu-lation, success, tracheal intubation

Cite and Share

THOMAS C. WASS,ADAM K. JACOB,SANDRA L. KOPP,LAURENCE C. TORSHER. A prospective randomized high fidelity simulation center based side-by-side comparison analyzing the success and ease of conventional versus new generation video laryngoscope technology by inexperienced laryngoscopists. Signa Vitae. 2011. 6(2);36-45.

References

1. Nouruzi-Sedeh P, Schumann M, Groeben H. Laryngoscopy via Macintosh blade versus GlideScope: success rate and time for endotra-cheal intubation in untrained medical personnel. Anesthesiology 2009;110:32-7.

2. Timmermann A, Russo SG, Crozier TA, Eich C, Mundt B, Albrecht B, et al. Novices ventilate and intubate quicker and safer via intubating laryngeal mask than by conventional bag-mask ventilation and laryngoscopy. Anesthesiology 2007;107:570-6.

3. Konrad C, Schupfer G, Wietlisbach M, Gerber H. Learning manual skills in anesthesiology: Is there a recommended number of cases for anesthetic procedures? Anesth Analg 1998;86:635-9.

4. Mulcaster JT, Mills J, Hung OR, MacQuarrie K, Law A, Pytka S, et al. Laryngoscopic intubation: learning and performance. Anesthesiology 2003;98:23-7.

5. Cormack RS, Lehane J. Difficult tracheal intubation in obstetrics. Anaesthesia 1984;39:1105-11.

6. Mallampati SR, Gatt SP, Gugino LD, Desai SP, Waraksa B, Freiberger D, et al. A clinical sign to predict difficult tracheal intubation: a pros-pective study. Can Anaesth Soc J 1985;32:429-34.

7. Flores AS, Garber SM, Niesen AD, Long TR, Lynch JJ, Wass CT. Clinical application of a novel video camera laryngoscope: a case series venturing beyond the normal airway. J Clin Anesth 2010;22:201-4.

8. Narang AT, Oldeg PF, Medzon R, Mahmood AR, Spector JA, Robinett DA. Comparison of intubation success of video laryngoscopy versus direct laryngoscopy in the difficult airway using high-fidelity simulation. Simul Healthc 2009;4:160-5.

9. O’Leary AM, Sandison MR, Myneni N, Cirilla DJ, Roberts KW, Deane GD. Preliminary evaluation of a novel videolaryngoscope, the McGrath series 5, in the management of difficult and challenging endotracheal intubation. J Clin Anesth 2008;20:320-1.

10. Shippey B, Ray D, McKeown D. Case series: the McGrath videolaryngoscope--an initial clinical evaluation. Can J Anaesth 2007;54:307-13.

11. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology 2003;98:1269-77.

12. Connelly NR, Ghandour K, Robbins L, Dunn S, Gibson C. Management of unexpected difficult airway at a teaching institution over a 7-year period. J Clin Anesth 2006;18:198-204.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time

Conferences

    Top