Learning curves of the Glidescope, the McGrath and the Airtraq laryngoscopes: a manikin study

Savoldelli, Georges Louis; Schiffer, Eduardo; Abegg, C.; Baeriswyl, V.; Clergue, F.; Waeber, Jean-Luc

doi:10.1097/eja.0b013e3283269ff4

Cited by 118 publications

(68 citation statements)

References 17 publications

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“…As in our study, another study reported that medical students preferred the Glidescope as their first choice (11)(12)(13)(14). All two video-laryngoscopes had a short learning curve and provided higher first intubation success rates in non-experienced hands, even in normal and difficult airways (15,16). However, all of them were performed in an adult population or adult manikin.…”

Section: Discussionsupporting

confidence: 60%

Intubation of a Paediatric Manikin in Tongue Oedema and Face-to-Face Simulations by Novice Personnel: a Comparison of Glidescope, Airtraq and Direct Laryngoscopy

Arslan¹,

Turna²,

Gümüş³

et al. 2016

Turk J Anaesth Reanim

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Amaç: Glidescope ve Airtraq entübasyonu kolaylaştırmak ve havayolu anatomisini öğretmek için geliştirilmişlerdir. Biz, bu havayolu araçlarının deneyimsiz personelce kullanımlarındaki etkinliklerini normal havayolu, dil ödemi ve yüz yüze entübasyon modellerinde değerlendirmeyi amaçladık.Yöntemler: Lokal İnsan Araştırmaları Etik Kurulu onayı alın-dıktan sonra tıp fakültesi 3. sınıf başlangıcında olan 36 öğrenci çalışmaya dahil edildi. Glidescope ve Airtraq ile pediyatrik maket üzerinde üç havayolu modelinde (sırasıyla); normal havayolu, dil ödemi ve yüz yüze entübasyon yapmışlardır. Bulgular:Yerleştirme ve entübasyon süreleri gruplar arasında benzer olmasına rağmen, Glidescope'un entübasyon başarı oranı normal havayolunda (%100 ve %67) ve dil ödeminde (%89 ve 50%) ile Airtraq'den fazladır (p=0,008 ve p=0,009). Maket üzerinde yüz yüze entübasyon başarı oranı gruplar arasında benzerdi (%50) (p=0,7). Manevra gereksinimi Glidescope grubunda normal ve dil ödemi modellerinde daha azdı (p=0,02 ve 0,002). Ek olarak, Glidescope ile özofagus entübasyonu normal ve dil ödeminde azdı (p=0,03 ve p<0,001).Sonuç: Deneyimsiz personel Glidescope ile Airtraq'e kıyasla trakeayı daha kolay entübe etmişlerdir. Glidescope ile entübasyon, normal ve dil ödemi modellerinde Airtraq'ten üstündür. Yüz yüze entübasyon başarı oranları hem Glidescope hem de Airtraq grubunda düşük bulunmuştur. Anahtar kelimeler: Laringoskoplar, havayolu yönetimi, entübas-yonObjective: Glidescope and Airtraq were designed for facilitating intubation and for teaching regarding the airway anatomy. We aimed to evaluate their efficacy in normal airway, tongue oedema and face-toface orotracheal intubation models when used by novice personnel. Methods:After the local human research ethics committee approval, 36 medical students who were in the beginning of their third year were enrolled in this study. After watching a video regarding intubation using one of these devices, the students intubated a paediatric manikin with a Glidescope or Airtraq via the normal airway, tongue oedema and face-to-face approach. Results:Although the insertion and intubation times were similar among the groups, the intubation success rate of the Glidescope was higher in the normal airway (100% vs 67%) and tongue oedema (89% vs. 50%) compared with the Airtraq (p=0.008 and p=0.009). The success rates with the paediatric manikin by the face-to-face approach were similar among the groups (50%) (p=0.7). The need for manoeuvres in the Glidescope was lower in the normal and tongue oedema models (p=0.02 and p=0.002). In addition, oesophageal intubation was low in the control and tongue oedema models with the Glidescope (p=0.03 and p<0.001). Conclusion:Novice personnel could more easily intubate the trachea with the Glidescope than with the Airtraq. Intubation with the Glidescope was superior to that with the Airtraq in the normal and tongue oedema models. The face-to-face intubation success rates were both low with both the Glidescope and Airtraq groups. Keywords: Laryngoscopes, airway management, int...

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Section: Discussionsupporting

confidence: 60%

Intubation of a Paediatric Manikin in Tongue Oedema and Face-to-Face Simulations by Novice Personnel: a Comparison of Glidescope, Airtraq and Direct Laryngoscopy

Arslan¹,

Turna²,

Gümüş³

et al. 2016

Turk J Anaesth Reanim

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“…In case of failure in providing airway within 2 min or failure in completing the procedure, the oesophageal intubation was considered unsuccessful. As in the study of Savoldelli et al (14), this study used the method of grading the applied pressure on teeth for measuring the severity of dental trauma: grade 0, no pressure; grade 1, mild; grade 2, moderate and grade 3, severe pressure. The participants were asked to reply to the question: 'If you consider the ease of use and learnability, which instrument would you prefer to use for intubation?'…”

Section: Methodsmentioning

confidence: 99%

Airtraq, LMA CTrach and Macintosh Laryngoscopes in Tracheal Intubation Training: A Randomized Comparative Manikin Study

Saraçoğlu¹,

Dal²,

Baygın³

et al. 2016

Turk J Anaesth Reanim

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Amaç: Hastalar ile doğrudan temasa izin vermeden önce öğrenci-lerin simülatörler üzerinde eğitimi kabul edilen bir tekniktir. Daha önce entübasyon deneyimi olmayan tıp öğrencileri tarafından gerçekleştirilen Airtraq, Laryngeal Mask Airway (LMA) CTrach ve Macintosh laringoskop ile trakeal entübasyonu karşılaştıran klinik veya manken -bazlı bir simülasyon çalışması bulunmamaktadır.Yöntemler: Yazılı bilgilendirilmiş onamların ardından, 123 katı-lımcı çalışmaya dahil edildi. Katılımcılardan rastgele her bir cihaz ile mankeni beş kez entübe etmeleri istendi. Tüm öğrenciler beşinci entübasyonu tamamladıktan sonra ölçümler yapıldı. Primer amaç birinci denemede başarı oranı, başarılı entübasyon zamanı, ikincil amaç dental travma, zorluk Görsel Analog Ölçeği ve optimizasyon manevralarını belirlemekti. Bulgular:Entübasyon girişim sayısı LMA CTrach grubunda anlamlı olarak daha yüksekti. Başarılı entübasyon için ortalama süre LMA CTrach grubunda en uzundu (17,66±8,22 sn, p<0,05). Öğrenciler öğrenme ve kullanma bakımından Airtraq'i en kolay, Macintosh laringoskopu ise en zor olarak tanımladı. Dental travma şiddeti Airtraq grubunda diğer gruplardan anlamlı olarak daha düşüktü (p<0,05) ve %81,1'inde 0 bulundu. Baş ekstansiyon optimizasyon manevra oranı Airtraq ile karşılaştırıldığında Macintosh laringoskop grubunda anlamlı olarak daha yüksekti (p<0,05).Sonuç: Farklı türde laringoskopların karşılaştırıldığı bu çalışmada Airtraq'in kısa entübasyon süresi, daha az ek optimizasyon manevraları, daha düşük dental travma şiddeti ve daha kolay öğrenilebi-lirliği ile avantajlı olduğu ortaya konulmuştur. Anahtar kelimeler: Havayolu, trakeal entübasyon, laringoskopObjective: Training students on simulators before allowing their direct contact with patients is well accepted. There is no clinical or manikin-based simulation study in the literature comparing tracheal intubation with Airtraq, laryngeal mask airway (LMA) CTrach and Macintosh laryngoscopes performed by medical students having no prior intubation experience. Methods:After obtaining written informed consents, 123 participants were included in the study. The participants were asked to intubate the manikin five times with each device randomly. After all the participants had completed their fifth intubations, the measurements were performed. The primary outcome variables were the first-attempt success rate and the time for a successful intubation, while the secondary outcome variables were to determine the scores of dental trauma, the difficulty visual analogue scale and the optimization manoeuvres. Results:The LMA CTrach group revealed a significantly higher number of intubation attempts. The mean time for a successful intubation was the longest in the LMA CTrach group (17.66±8.22 s, p<0.05). Students defined the Airtraq as the easiest to use and the Macintosh laryngoscope as the most difficult device to use and learn. Dental trauma severity was significantly lower in the Airtraq group than in the other groups (p<0.05), and it was found to be 0 in 81.1% in the Airtraq group. The h...

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“…Lees et al demonstrated a learning curve over 20 intubations in children in expert anaesthetists, but reported an incidence of failed intubations higher than with direct laryngoscopy, again raising substantial doubts that expertise had been reached [14]. Savoldelli et al also defined a list of criteria, including Cormach and Lehane grade, subjective difficulty and number of attempts to represent the complexity of intubation task, with both direct and videolaryngoscopy [15].…”

Section: Introductionmentioning

confidence: 99%

Defining and developing expertise in tracheal intubation using a GlideScope^® for anaesthetists with expertise in Macintosh direct laryngoscopy: an in‐vivo longitudinal study

et al. 2014

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SummaryAlthough videolaryngoscopy can provide excellent views of the laryngeal structures as both the primary method of tracheal intubation and as a rescue technique for difficult direct laryngoscopy, the existing literature is inadequate to define expertise or even competence. We observed the performance of nine trainees during 890 intubations, with an additional 72 intubations performed by expert anaesthetists used as a control group. Univariate and multivariate mixed-effects logistic regression models were applied to detect potential predictors of successful intubation and define the number of intubations necessary for a trainee to achieve expertise (> 90% probability of optimal performance). Optimal performance was predicted by single laryngoscope insertion (p < 0.001) and a Cormack and Lehane grade-1 view (p < 0.001), and not by normal lifting force applied to the device (p = 0.15), with expertise reached after 76 attempts. These results indicate that expertise in videolaryngoscopy requires prolonged training and practice.

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Learning curves of the Glidescope, the McGrath and the Airtraq laryngoscopes: a manikin study

Cited by 118 publications

References 17 publications

Intubation of a Paediatric Manikin in Tongue Oedema and Face-to-Face Simulations by Novice Personnel: a Comparison of Glidescope, Airtraq and Direct Laryngoscopy

Intubation of a Paediatric Manikin in Tongue Oedema and Face-to-Face Simulations by Novice Personnel: a Comparison of Glidescope, Airtraq and Direct Laryngoscopy

Airtraq, LMA CTrach and Macintosh Laryngoscopes in Tracheal Intubation Training: A Randomized Comparative Manikin Study

Defining and developing expertise in tracheal intubation using a GlideScope^® for anaesthetists with expertise in Macintosh direct laryngoscopy: an in‐vivo longitudinal study

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Learning curves of the Glidescope, the McGrath and the Airtraq laryngoscopes: a manikin study

Cited by 118 publications

References 17 publications

Intubation of a Paediatric Manikin in Tongue Oedema and Face-to-Face Simulations by Novice Personnel: a Comparison of Glidescope, Airtraq and Direct Laryngoscopy

Intubation of a Paediatric Manikin in Tongue Oedema and Face-to-Face Simulations by Novice Personnel: a Comparison of Glidescope, Airtraq and Direct Laryngoscopy

Airtraq, LMA CTrach and Macintosh Laryngoscopes in Tracheal Intubation Training: A Randomized Comparative Manikin Study

Defining and developing expertise in tracheal intubation using a GlideScope® for anaesthetists with expertise in Macintosh direct laryngoscopy: an in‐vivo longitudinal study

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Defining and developing expertise in tracheal intubation using a GlideScope^® for anaesthetists with expertise in Macintosh direct laryngoscopy: an in‐vivo longitudinal study