Comparison of seven videolaryngoscopes with the Macintosh laryngoscope in manikins by experienced and novice personnel

Abstract

Summary Videolaryngoscopy is often reserved for ‘anticipated’ difficult airways, but thereby can result in a higher overall rate of complications. We observed 65 anaesthetists, 67 residents in anaesthesia, 56 paramedics and 65 medical students, intubating the trachea of a standardised manikin model with a normal airway using seven devices: Macintosh classic laryngoscope, Airtraq®, Storz C‐MAC®, Coopdech VLP‐100®, Storz C‐MAC D‐Blade®, GlideScope Cobalt®, McGrath Series5® and Pentax AWS®) in random order. Time to and proportion of successful intubation, complications and user satisfaction were compared. All groups were fastest using devices with a Macintosh‐type blade. All groups needed significantly more attempts using the Airtraq and Pentax AWS (all p < 0.05). Devices with a Macintosh‐type blade (classic laryngoscope and C‐MAC) scored highest in user satisfaction. Our results underline the importance of variability in device performance across individuals and staff groups, which have important implications for which devices hospital providers should rationally purchase.

Comparison of VividTrac®, Airtraq®, King Vision®, Macintosh Laryngoscope and a Custom-Made Videolaryngoscope for difficult and normal airways in mannequins by novices

“…The LT and IT were shorter in our study than in previous reports regarding the use of DL, KV and AT, which is likely due to the short time gap between the training and evaluation sessions [2, 11, 20]. The duration of demonstration was the same as reported by Maharaj et al, although this time was 10 min longer than in the Pieters study [2, 11].…”

“…The duration of demonstration was the same as reported by Maharaj et al, although this time was 10 min longer than in the Pieters study [2, 11]. The type of the airway trainer did not differ, but training was not allowed in the aforementioned previous studies, unlike in our evaluation, which may have influenced our results [2, 11].…”

“…The duration of demonstration was the same as reported by Maharaj et al, although this time was 10 min longer than in the Pieters study [2, 11]. The type of the airway trainer did not differ, but training was not allowed in the aforementioned previous studies, unlike in our evaluation, which may have influenced our results [2, 11]. Cohen et al reported that ITs were comparable to those of the Glidescope based on the ID, while we noted longer intubation times, similar to Karippacheril et al [6, 8].…”

“…Each endotracheal intubation was performed with a standard 7.5-mm internal diameter, cuffed, plastic endotracheal tube (Mallinckrodt®, Covidien, Dublin, Ireland). Demonstrations, training and evaluations were all performed on the Laerdal® Airway Management Trainer (Laerdal®, Stavanger, Norway) [2, 10, 11, 14]. …”

“…Although DL is a well-known and reliable technique in the hands of an experienced operator, airway management is an urgent task that may need to be carried out regardless of specialty background to prevent impending disastrous complications, such as hypoxia and aspiration [1, 2]. Videolaryngoscopy (VL) might be beneficial compared to DL for novices, although the role of VL in airway management remains controversial [3, 4].…”