A Randomized Comparison Simulating Face to Face Endotracheal Intubation of Pentax Airway Scope, C-MAC Video Laryngoscope, Glidescope Video Laryngoscope, and Macintosh Laryngoscope

Abstract

Objectives. Early airway management is very important for severely ill patients. This study aimed to investigate the efficacy of face to face intubation in four different types of laryngoscopes (Macintosh laryngoscope, Pentax airway scope (AWS), Glidescope video laryngoscope (GVL), and C-MAC video laryngoscope (C-MAC)). Method. Ninety-five nurses and emergency medical technicians were trained to use the AWS, C-MAC, GVL and Macintosh laryngoscope with standard airway trainer manikin and face to face intubation. We compared VCET (vocal cord exposure time), tube pass time, 1st ventilation time, VCET to tube pass time, tube pass time to 1st ventilation time, and POGO (percentage of glottis opening) score. In addition, we compared success rate according to the number of attempts and complications. Result. VCET was similar among all laryngoscopes and POGO score was higher in AWS. AWS and Macintosh blade were faster than GVL and C-MAC in total intubation time. Face to face intubation success rate was lower in GVL than other laryngoscopes. Conclusion. AWS and Macintosh were favorable laryngoscopes in face to face intubation. GVL had disadvantage performing face to face intubation.

A comparison of direct laryngoscopy to video laryngoscopy by paramedic students in manikin-simulated airway management scenarios

“…Similar to our observations, Choi et al [13] attributes this to the significant hand-eye discordance which appears to occur when the VL is used in this unconventional situation. The finding in our study that use of VL was also associated to an increased risk of failed intubations (RR: 6.4, CI 0.95; 0.92–44.33, p = 0.018) and that of Choi et al [13] suggests that DL remains the technique of choice in the restricted space face-to-face scenario, and VL should not be used in these situations. Our findings also suggest that in the hands of novice prehospital providers VL does not appear offer any additional advantage over DL in the simulated setting for intubation success, although other studies have indicated contradictory findings [11] .…”

“…Contrary to this our results in fact indicated the opposite. These findings correlate with that of Choi et al [13] who, at same period of our data collection, conducted a similarly study comparing different VL and DL devices in the restricted space face-to-face intubation scenario. Choi et al [13] reported that intubation time was significantly improved with the use of the DL (Macintosh and Pentax Airway Scope), as compared to the C-MAC and Glidescope VL systems.…”

“…These findings correlate with that of Choi et al [13] who, at same period of our data collection, conducted a similarly study comparing different VL and DL devices in the restricted space face-to-face intubation scenario. Choi et al [13] reported that intubation time was significantly improved with the use of the DL (Macintosh and Pentax Airway Scope), as compared to the C-MAC and Glidescope VL systems. Similar to our observations, Choi et al [13] attributes this to the significant hand-eye discordance which appears to occur when the VL is used in this unconventional situation.…”

“…Choi et al [13] reported that intubation time was significantly improved with the use of the DL (Macintosh and Pentax Airway Scope), as compared to the C-MAC and Glidescope VL systems. Similar to our observations, Choi et al [13] attributes this to the significant hand-eye discordance which appears to occur when the VL is used in this unconventional situation. The finding in our study that use of VL was also associated to an increased risk of failed intubations (RR: 6.4, CI 0.95; 0.92–44.33, p = 0.018) and that of Choi et al [13] suggests that DL remains the technique of choice in the restricted space face-to-face scenario, and VL should not be used in these situations.…”

Sitting Nasal Intubation With Fiberoptic in an Elective Mandible Surgery Under General Anesthesia

“…Sitting endotracheal intubation is a useful technique for airway control, in patients with difficult airway or in patients in whom maintenance of the upright posture is beneficial ( 3 ), such as patients with tracheal compression ( 4 ), or superior vena cava syndrome ( 5 , 6 ). The technique consists of advancing the endotracheal tube to vocal cords of patient in face-to-face position, when patient is in the sitting or semi-sitting position ( 7 ).…”