Comparison of intubation through the McGrath MAC, GlideScope, AirTraq, and Miller Laryngoscope by paramedics during child CPR: a randomized crossover manikin trial

Szarpak, Łukasz; Karczewska, Katarzyna; Evrın, Togay; Kurowski, Andrzej; Czyżewski, Łukasz

doi:10.1016/j.ajem.2015.04.017

Cited by 31 publications

(17 citation statements)

References 25 publications

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“…In this study, in contrast with other VLs, McGrath VL showed a similar time to intubation (median [IQR]) to that with Macintosh laryngoscopy (25 [23–28] s vs 26 [24–29] s) along with a better glottic view. The intubation time with McGrath VL in this study may be acceptable in the context of a previous paediatric manikin study using McGrath VL (30.7 ± 15.3 s); paediatric Airtraq VL also did not prolong the time to intubation in the aforementioned meta‐analysis, but it was not easy to use, especially in small children . Guiding the endotracheal tube into the vocal cords was not always straightforward, despite a superior laryngeal view; the paediatric Airtraq has a relatively wide tracheal tube channel and a relatively long blade compared with adult sizes, and thus, there is more space between the tip of the laryngoscope and the tracheal tube …”

Section: Discussionmentioning

confidence: 59%

“…In paediatric manikins that received simulated CPR, the success rate on intubation during paramedics’ first attempt using McGrath VL was 86.3% . In this study, because all paediatric tracheal intubations were performed by one expert anaesthesiologist, it is not surprising that the success rate was considerably high and did not increase after the use of the McGrath VL (98% in both).…”

Section: Discussionmentioning

confidence: 67%

“…Because each VL has unique characteristics and advantages for different situations, it is reasonable to evaluate each separately. Recently, the McGrath VL showed intubation effectiveness when inexperienced paramedics conducted cardiopulmonary resuscitations of paediatric manikins . One study's authors described the usefulness of McGrath VL, with which 100 children were easily intubated without complications .…”

mentioning

confidence: 99%

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A comparison between McGrath MAC videolaryngoscopy and Macintosh laryngoscopy in children

Kim

Kwak

Jung

et al. 2017

Acta Anaesthesiol Scand

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 67%

mentioning

confidence: 99%

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A comparison between McGrath MAC videolaryngoscopy and Macintosh laryngoscopy in children

Kim

Kwak

Jung

et al. 2017

Acta Anaesthesiol Scand

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“…In this regard, video laryngoscopes were found to provide a great visualization of the glottis (10) and to improve endotracheal intubation success rates (24). The GlideScope video laryngoscope (Verathon) has been evaluated in manikin studies (19,20,25), the operating room (7,26,27), emergency departments (28), and ICUs (9,18). There is evidence that especially subjects at higher risk of a difficult airway benefit from GlideScope-assisted intubation (26,29,30).…”

Section: Discussionmentioning

confidence: 98%

Use of the GlideScope Ranger Video Laryngoscope for Emergency Intubation in the Prehospital Setting: A Randomized Control Trial*

Trimmel¹,

Kreutziger

Fitzka³

et al. 2016

Critical Care Medicine

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“…Important advantages of the McGrath are that providers are usually already familiar with the Macintosh blade and furthermore it allows the option of either direct or indirect view of the glottis with one line of sight [14]. Previously, the McGrath was reported to be faster and enable a higher first-attempt intubation success rate in children, even during ongoing chest compressions [26, 27]. However, whether the McGrath is effective in children with difficult airways, such as those with cervical immobilization, is unclear.…”

Section: Introductionmentioning

confidence: 99%

A comparison of McGrath MAC® and standard direct laryngoscopy in simulated immobilized cervical spine pediatric intubation: a manikin study

et al. 2017

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Emergency airway management in children is generally considered to be challenging, and endotracheal intubation requires a high level of personal skills and experience. Immobilization of the cervical spine is indicated in all patients with the risk of any cervical spine injury but significantly aggravates endotracheal intubation. The best airway device in this setting has not been established yet, although the use of videolaryngoscopes is generally promising. Seventy-five moderately experienced paramedics of the Emergency Medical Service of Poland performed endotracheal intubations in a pediatric manikin in three airway scenarios: (A) normal airway, (B) manual in-line cervical immobilization, and (C) cervical immobilization using a Patriot cervical extrication collar and using two airway techniques: (1) McGrath videolaryngoscope and (2) Macintosh blade in a randomized sequence. First-attempt intubation success rate, time to intubation, glottis visualization, and subjective ease of intubation were investigated in this study. Intubation of difficult airways, including manual in-line and cervical collar immobilization, using the McGrath was significantly faster, with a higher first-attempt intubation success rate, better glottic visualization, and ease of intubation, compared to Macintosh-guided intubation. In the normal airway, both airway techniques performed equal. Conclusion: Our manikin study indicates that the McGrath may be a reasonable first intubation technique option for endotracheal intubation in difficult pediatric emergencies. Further clinical studies are therefore indicated. What is known : • Airway management in pediatrics is challenging and requires a high level of skills and experience. Cervical immobilization is indicated in all patients with any risk of cervical spine injury, but it significantly aggravates endotracheal intubation in these patients. Videolaryngoscopes have been reported to ease intubation and provide better airway visualization in the regular clinical setting. What is new: • The McGrath is an easy-to-use and clinically often used videolaryngoscope, but it has never been investigated in pediatrics with an immobilized cervical spine. In the normal airway, the McGrath provided better airway visualization compared to Macintosh laryngoscopy. However, better visualization did not lead to decreased time to intubation and a higher success rate of the first intubation attempt. In difficult airways, the McGrath provided better airway visualization and this led to faster intubation, a higher first-attempt intubation success rate, and better ease of intubation compared to Macintosh-guided intubation.

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Comparison of intubation through the McGrath MAC, GlideScope, AirTraq, and Miller Laryngoscope by paramedics during child CPR: a randomized crossover manikin trial

Cited by 31 publications

References 25 publications

A comparison between McGrath MAC videolaryngoscopy and Macintosh laryngoscopy in children

A comparison between McGrath MAC videolaryngoscopy and Macintosh laryngoscopy in children

Use of the GlideScope Ranger Video Laryngoscope for Emergency Intubation in the Prehospital Setting: A Randomized Control Trial*

A comparison of McGrath MAC® and standard direct laryngoscopy in simulated immobilized cervical spine pediatric intubation: a manikin study

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