Comparison of seven videolaryngoscopes with the Macintosh laryngoscope in manikins by experienced and novice personnel

Abstract

Videolaryngoscopy is often reserved for 'anticipated' difficult airways, but thereby can result in a higher overall rate of complications. We observed 65 anaesthetists, 67 residents in anaesthesia, 56 paramedics and 65 medical students, intubating the trachea of a standardised manikin model with a normal airway using seven devices: Macintosh classic laryngoscope, Airtraq(®) , Storz C-MAC(®) , Coopdech VLP-100(®) , Storz C-MAC D-Blade(®) , GlideScope Cobalt(®) , McGrath Series5(®) and Pentax AWS(®) ) in random order. Time to and proportion of successful intubation, complications and user satisfaction were compared. All groups were fastest using devices with a Macintosh-type blade. All groups needed significantly more attempts using the Airtraq and Pentax AWS (all p < 0.05). Devices with a Macintosh-type blade (classic laryngoscope and C-MAC) scored highest in user satisfaction. Our results underline the importance of variability in device performance across individuals and staff groups, which have important implications for which devices hospital providers should rationally purchase.

Keywords: airway management; education; equipment; simulation; videolaryngoscopy.