Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Dec 28;2(4):244-249.
doi: 10.15441/ceem.15.043. eCollection 2015 Dec.

Comparison of intubation times using a manikin with an immobilized cervical spine: Macintosh laryngoscope vs. GlideScope vs. fiberoptic bronchoscope

Jung-In Ko  1 , Sang Ook Ha  2 , Min Seok Koo  3 , Miyoung Kwon  3 , Jieun Kim  3 , Jin Jeon  4 , So Hee Park  5 , Sangwoo Shim  6 , Youjin Chang  7 , Taejin Park  1
Affiliations

Comparison of intubation times using a manikin with an immobilized cervical spine: Macintosh laryngoscope vs. GlideScope vs. fiberoptic bronchoscope

Jung-In Ko et al. Clin Exp Emerg Med. .

Abstract

Objective: Airway management in patients with suspected cervical spine injury is classified as a "difficult airway." The best device for managing difficult airways is not known. Therefore, we conducted an intubation study simulating patients with cervical spine injury using three devices: a conventional Macintosh laryngoscope, a video laryngoscope (GlideScope), and a fiberoptic bronchoscope (MAF-TM). Success rates, intubation time, and complication rates were compared.

Methods: Nine physician experts in airway management participated in this study. Cervical immobilization was used to simulate a difficult airway. Each participant performed intubation using airway devices in a randomly chosen order. We measured the time to vocal cord visualization, time to endotracheal tube insertion, and total tracheal intubation time. Success rates and dental injury rates were compared between devices.

Results: Total tracheal intubation time using the Macintosh laryngoscope, GlideScope, and fiberoptic bronchoscope was 13.3 (range, 11.1 to 20.1), 14.9 (range, 12.7 to 22.3), and 19.4 seconds (range, 14.1 to 32.5), respectively. Total tracheal intubation time differed significantly among the devices (P=0.009). Success rates for the Macintosh laryngoscope, GlideScope, and fiberoptic bronchoscope were 98%, 96%, and 100%, respectively, and dental injury rates were 5%, 19%, and 0%, respectively.

Conclusion: The fiberoptic bronchoscope required longer intubation times than the other devices. However, this device had the best success rate with the least incidence of dental injury.

Keywords: Airway management; Bronchoscope; Head trauma.

PubMed Disclaimer

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Total intubation time using each intubation device. *P=0.008. **P=0.024.
Fig. 2.
Fig. 2.
Visualization of the vocal cords using each device (A). Endotracheal (ET) tube insertion time using each device (B). *P=0.047. **P=0.003.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. American Society of Anesthesiologists Task Force on Management of the Difficult Airway 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. - PubMed
    1. Crosby ET, Lui A. The adult cervical spine: implications for airway management. Can J Anaesth. 1990;37:77–93. - PubMed
    1. American College of Surgeons . Advanced trauma life support for doctors ATLS: manuals for coordinators and faculty. 8th ed. Chicago, IL: American College of Surgeons; 2008.
    1. Majernick TG, Bieniek R, Houston JB, Hughes HG. Cervical spine movement during orotracheal intubation. Ann Emerg Med. 1986;15:417–20. - PubMed
    1. Manoach S, Paladino L. Manual in-line stabilization for acute airway management of suspected cervical spine injury: historical review and current questions. Ann Emerg Med. 2007;50:236–45. - PubMed

LinkOut - more resources