Comparison of the ETView Single Lumen and Macintosh laryngoscopes for endotracheal intubation in an airway manikin with immobilized cervical spine by novice paramedics

Abstract

Context:Management of the airway of a trauma victim is considered challenging. Various approaches have been described to achieve airway control in this setup; many of them include video-assited viewing of the larynx during intubation. ETView Single Lumen (SL) is a novice single-use endotracheal tube equiped with a video camera and a light source at its distal tip. Its use was previously described in seeral clinical and training setups.Objective:The aim was to evaluate the efficacy of the VivaSight SL compared with classic direct laryngoscopy performed with a Macintosh blade in a manikin-simulated trauma setup presenting various degrees of airway challenge when performed by inexperienced physicians.Design, Setting, Participants:This was prospective, randomized, crossover, manikin trial. After short training on the ETView system, 67 novice paramedics attempted to perform oral intubation using both standard direct laryngoscopy (MAC group) and the VivaSight SL endotracheal tube (ETView group) in a randomized order on manikins in 3 increasingly more difficult scenarios (simple intubation, cervical spine manual stabilization, and with cervical collar in place).Outcome Measure:Overall success rate, time to intubation, number of intubation attempts, laryngeal view grade, dental compression, and overall participant satisfaction were monitored.Results:Duration of intubation and number of attempts were significantly superior in the ETView group in the latter 2 more challenging scenarios. All other parameters showed superiority to the ETView group in all 3 scenarios.Conclusion:The VivaSight SL system performed better in a complex scenario of airway management of a trauma victim in need for cervical spine stabilization performed by novice caregivers compared to standard direct laryngoscopy and should be considered in this clinical setup.

VivaSight single-lumen tube as an intubation method. A systematic review and meta-analysis of randomised simulation trials

“…100% effectiveness of intubation with the discussed methods was also observed by Gawłowski et al in the cervical spine man-fIGuRe 6. Overall success rate ual immobilisation scenario [12], as well as Truszewski et al intubating patients face to face [20]. The above results are all the more important because the personnel participating in them (physicians, nurses, or paramedics) had no previous experience in videolaryngoscopy.…”

Successful one-lung ventilation using the VivaSight-EB bronchial blocker tube for an emergency lung injury. A simulation pilot data

“…The effectiveness of this method is confirmed by numerous publications. In Gawlowski et al [20], as in the case of Kurowski et al [13] intubators were able to intubate with ETView SL after a short training session with high efficacy in various emergency scenarios. Also, studies conducted by Truszewski et al [14] indicate high efficacy of ETView intubation under normal conditions, chest compression during simulated cardiopulmonary resuscitation or cervical spine immobilization.…”

“…The effectiveness of the first attempt to protect the bronchi with a bronchial blocker was 26% for both scenarios and the total effectiveness of bronchial protection was 100% in both cases. Time T1 for endotracheal intubation was 18sec for Scenario A (IQR; and 20 sec for Scenario B (IQR;[17][18][19][20][21][22][23][24][25]. The time to perform one-lung ventilation (Time T2) in scenarios A and B was 43 sec (IQR; 38-62.5) vs. 43.5 sec (38-65).…”

Comparison of the McGrath MAC EMS Videolaryngoscope with a Conventional Laryngoscope for Standard and Difficult Airway Intubation: A Randomized, Cross-over, Simulation Trial

“…It should be remembered that each intubation performed within an emergency medical service is emergency intubation (24). The lack of information on patient status and medical history, inability to conduct an anesthesia consultation in many cases, as well as the lack of knowledge of the recent meal, make each patient in the pre-hospital conditions and the emergency department considered as a patient with difficult airways (25). In our study, the efficacy of the first intubation attempt and the total efficacy of intubation under normal airway were comparable for direct laryngoscopy and McGrath videolaryngoscopy.…”