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. 2020 Feb 18:2020:5382739.
doi: 10.1155/2020/5382739. eCollection 2020.

Comparison of Direct and Video Laryngoscopes during Different Airway Scenarios Performed by Experienced Paramedics: A Randomized Cross-Over Manikin Study

Kurt Ruetzler  1 , Lukasz Szarpak  2 , Jacek Smereka  3 , Marek Dabrowski  4 , Szymon Bialka  5 , Lauretta Mosteller  6 , Agnieszka Szarpak  7 , Kobi Ludwin  7 , Marzena Wojewodzka-Zelezniakowicz  8 , Jerzy Robert Ladny  8
Affiliations

Comparison of Direct and Video Laryngoscopes during Different Airway Scenarios Performed by Experienced Paramedics: A Randomized Cross-Over Manikin Study

Kurt Ruetzler et al. Biomed Res Int. .

Abstract

Introduction. Airway management plays an essential role in anaesthesia practice, during both elective and urgent surgery procedures and emergency medicine.

Aim: The aim of the study was to compare Macintosh laryngoscope (MAC), McGrath, and TruView PCD in 5 separate airway management scenarios.

Methods: This prospective cross-over simulation study involved 93 paramedics. All paramedics performed intubation using direct laryngoscope (MAC), McGrath, and TruView PCD video laryngoscopes. The study was performed in 5 different scenarios: (A) normal airway, (B) tongue oedema, (C) pharyngeal obstruction, (D) cervical collar stabilization with tongue oedema, and (E) cervical collar stabilization with pharyngeal obstruction.

Results: In scenario A, the success rate was 99% with MAC, 100% with McGrath, and 94% with PCD. Intubation time was 17 s (IQR: 16-21) for MAC, 18 s (IQR: 16-21) for McGrath, and 27 s (IQR: 23-34) for PCD. In scenario B, the success rate was 61% with MAC, 97% with McGrath, and 97% with PCD (p < 0.001). Intubation time was 44 s (IQR: 24-46) for MAC, 22 s (IQR: 20-27) for McGrath, and 39 s (IQR: 30-57) for PCD. In scenario C, the success rate with MAC was 74%, 97% with McGrath, and 72% with PCD (p < 0.001). Intubation time was 44 s (IQR: 24-46) for MAC, 22 s (IQR: 20-27) for McGrath, and 39 s (IQR: 30-57) for PCD. In scenario C, the success rate with MAC was 74%, 97% with McGrath, and 72% with PCD (p < 0.001). Intubation time was 44 s (IQR: 24-46) for MAC, 22 s (IQR: 20-27) for McGrath, and 39 s (IQR: 30-57) for PCD. In scenario C, the success rate with MAC was 74%, 97% with McGrath, and 72% with PCD (p < 0.001). Intubation time was 44 s (IQR: 24-46) for MAC, 22 s (IQR: 20-27) for McGrath, and 39 s (IQR: 30-57) for PCD. In scenario C, the success rate with MAC was 74%, 97% with McGrath, and 72% with PCD (.

Conclusions: The McGrath video laryngoscope proved better than Truview PCD and direct intubation with Macintosh laryngoscope in terms of success rate, duration of first intubation attempt, number of intubation attempts, Cormack-Lehane grade, percentage of glottis opening (POGO score), number of optimization manoeuvres, severity of dental compression, and ease of use.

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Conflict of interest statement

The authors declare no conflicts of interest regarding the publication of this paper.

Figures

Figure 1
Figure 1
Laryngoscopes used in this study: (a) Macintosh laryngoscope; (b) McGrath MAC video laryngoscope; (c) TruView PCD video laryngoscope.
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