A comparison of the ETView VivaSight SL against a fiberoptic bronchoscope for nasotracheal intubation of multitrauma patients during resuscitation. A randomized, crossover, manikin study

Background:Airway management is a crucial skill essential to paramedics and personnel working in Emergency Medical Services and Emergency Departments: Lack of practice, a difficult airway, or a trauma situation may limit the ability of paramedics to perform direct laryngoscopy during cardiopulmonary resuscitation. Videoscope devices are alternatives for airway management in these situations. The ETView VivaSight SL (ETView; ETView Ltd., Misgav, Israel) is a new, single-lumen airway tube with an integrated high-resolution imaging camera. To assess if the ETView VivaSight SL can be a superior alternative to a standard endotracheal tube for intubation in an adult cadaver model, both during and without simulated CPR.Methods:ETView VivaSight SL tube was investigated via an interventional, randomized, crossover, cadaver study. A total of 52 paramedics participated in the intubation of human cadavers in three different scenarios: a normal airway at rest without concomitant chest compression (CC) (scenario A), a normal airway with uninterrupted CC (scenario B) and manual in-line stabilization (scenario C). Time and rate of success for intubation, the glottic view scale, and ease-of-use of ETView vs. sETT intubation were assessed for each emergency scenario.Results:The median time to intubation using ETView vs. sETT was compared for each of the aforementioned scenarios. For scenario A, time to first ventilation was achieved fastest for ETView, 19.5 [IQR, 16.5–22] sec, when compared to that of sETT at 21.5 [IQR, 20–25] sec (p = .013). In scenario B, the time for intubation using ETView was 21 [IQR, 18.5–24.5] sec (p < .001) and sETT was 27 [IQR, 24.5–31.5] sec. Time to first ventilation for scenario C was 23.5 [IQR, 19–25.5] sec for the ETView and 42.5 [IQR, 35–49.5] sec for sETT.Conclusions:In normal airways and situations with continuous chest compressions, the success rate for intubation of cadavers and the time to ventilation were improved with the ETView. The time to glottis view, tube insertion, and cuff block were all found to be shorter with the ETView.Trial Registration:clinicaltrials.gov Identifier: NCT02733536.

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“…In addition, the ETView has proven superior to sETT during resuscitation via simulated multitrauma studies. [ 7 ]…”

Section: Discussionmentioning

confidence: 99%

“…Evidence has indicated that the ETView may be suitable for tracheal intubation in various settings where standard ETI cannot be performed. [ 6 , 7 , 8 ]…”

Section: Introductionmentioning

confidence: 99%

A comparison of a traditional endotracheal tube versus ETView SL in endotracheal intubation during different emergency conditions

Truszewski¹,

Krajewski

Fudalej

et al. 2016

Medicine

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“…However, such maneuvers within the cervical spine are accepted only in non-traumatic patients. In the case of trauma patients (both adults and children), the immobilization of the cervical spine in order to reduce the possibility of injury is essential [4][5][6]. This limitation could result in the worsening of glottis visibility and less effective endotracheal intubation [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…In the case of trauma patients (both adults and children), the immobilization of the cervical spine in order to reduce the possibility of injury is essential [4][5][6]. This limitation could result in the worsening of glottis visibility and less effective endotracheal intubation [5,6]. During endotracheal intubation in children, most health professionals commencing endotracheal intubation in a direct laryngoscopy use a straight Miller laryngoscope blade.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Miller and Macintosh laryngoscopes in simulated pediatric trauma patient: a pilot study

Wojewódzka-Żelezniakowicz

Madziala²,

Madziała

2017

Disaster Emerg Med J

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INTRODUCTION: Airway management in pediatric trauma patients is challenging. Direct laryngoscopy is the gold standard for endotracheal intubation in emergency and trauma patients. The aim of the present study was to evaluate the performance of Miller (MIL) and Macintosh (MAC) laryngoscopes when employed in emergency pediatric intubation scenarios. METHODS: This was a prospective, randomized, crossover, single-center study on novice physicians recruited on a voluntary basis. Each participant performer endotracheal intubation using Miller or Macintosh laryngoscopes during two airway scenarios: Scenario A-normal airway; Scenario B-difficult airway, defined as scenario in which the patient was placed on backboard with neck immobilization performer using rigid cervical collar. The order of use of one or other of the devices was randomized with a ratio of 1:1. The primary endpoint was the first attempt success rate. RESULTS: The effectiveness of the first intubation attempt in Scenario B for MAC was 36.8%, for MIL-44.7%; while in Scenario A for MAC this was 36.8%, for MIL-44.7%. During Scenario A, the median duration time of intubation using MIL was 24.5 s [IQR; 21-32.5] and 23 s [IQR; 20.5-31] for MAC. During Scenario B, median intubation time with the MAC laryngoscope was 40.5 [IQR; 36.5-47] s, and with MIL 37.5 [IQR; 33-44.5] seconds. CONCLUSIONS: We concluded that in trauma pediatric patients the Miller laryngoscope is associated with higher first attempt success rates than the Macintosh laryngoscope. These data suggest that for patients with cervical spine immobilization, the Miller laryngoscope should be the preferred method of intubation in emergency medicine conditions.

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“…Dear Editor, Endotracheal intubation has proved to be the best method for airway management for trauma victims [1][2][3]. Medical rescue teams provide advanced airway management using various methods [4], including supraglotic airway devices [5,6], direct laryngoscopy, as well as optical-video laryngoscopy. It should be mentioned that endotracheal intubation remains the gold standard in number of emergency trauma victims in whom a higher risk of vomiting and airway obstruction due to a trauma of the central nervous system and altered mental status is observed.…”

mentioning

confidence: 99%

Alternative of endotracheal intubation for paramedics to provide direct laryngoscopy. The randomized manikin trial

Kłosiewicz

Sip

Zalewski

et al. 2017

Disaster Emerg Med J

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A comparison of the ETView VivaSight SL against a fiberoptic bronchoscope for nasotracheal intubation of multitrauma patients during resuscitation. A randomized, crossover, manikin study

Cited by 22 publications

References 4 publications

A comparison of a traditional endotracheal tube versus ETView SL in endotracheal intubation during different emergency conditions

A comparison of a traditional endotracheal tube versus ETView SL in endotracheal intubation during different emergency conditions

Comparison of the Miller and Macintosh laryngoscopes in simulated pediatric trauma patient: a pilot study

Alternative of endotracheal intubation for paramedics to provide direct laryngoscopy. The randomized manikin trial

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