Seeing is believing: the importance of video laryngoscopy in teaching and in managing the difficult airway

Kaplan, Marshal B.; Ward, Denham S.; Hagberg, Carin A.; Berci, George; Hagiike, Masanobu

doi:10.1007/s00464-006-0038-z

Cited by 38 publications

(24 citation statements)

References 12 publications

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“…It has been suggested that video laryngoscope systems are ideal for teaching the technique of tracheal intubation primarily because of their ability to allow the trainer and trainee to share identical views [4,[6][7][8][9]. The trainer can give advice on optimising the view, using the BERCI DCI Video Laryngoscope, and pass the tracheal tube.…”

Section: Discussionmentioning

confidence: 99%

The use of the BERCI DCI^® Video Laryngoscope for teaching novices direct laryngoscopy and tracheal intubation*

2008

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SummaryTraditional teaching of laryngoscopy is difficult due to the trainer and trainee lacking a shared view. The Karl Storz BERCI DCI Ò Video Laryngoscope provides a video image for the trainer and a direct view identical to that of a standard laryngoscope for the trainee. Forty-nine novice subjects were randomly assigned to a control group (n = 24) taught using a standard Macintosh laryngoscope or a study group (n = 25) taught using the Video Laryngoscope. Following training all subjects were assessed using a standard laryngoscope. Under simulated difficult airway conditions the study group performed better in terms of number of attempts (p = 0.02), number of repositioning manoeuvres required (p = 0.046) and teeth trauma (p = 0.034). The study group were more confident of the success of their tube placement (p = 0.035), found it easier than the control group (p = 0.042) and had improved knowledge of airway anatomy (p = 0.011). We conclude that video laryngoscopy confers benefits in the teaching of tracheal intubation.

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Section: Discussionmentioning

confidence: 99%

The use of the BERCI DCI^® Video Laryngoscope for teaching novices direct laryngoscopy and tracheal intubation*

2008

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“…The mouth and pharyngeal tract is not necessary to view the glottis by indirect laryngoscopy. Bringing the pharyngeal and laryngeal axes, which have a close degree of slope to the same plane, is adequate to view the glottis (8). Many indirect laryngoscopes with different shapes and imaging technologies have been produced recently due to these advantages.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the C-MAC D-Blade, Conventional C-MAC, and Macintosh Laryngoscopes in Simulated Easy and Difficult Airways

Kılıçaslan¹,

Topal²,

Erol³

et al. 2014

Turk J Anesth Reanim

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Objective: Recently, to further enhance the potential in the management of difficult airways, the highly angulated D-Blade was added to the C-MAC system. The purpose of this study was to investigate the laryngoscopic view and intubation parameters using the new C-MAC D-Blade in comparison to the conventional C-MAC video laryngoscope and Macintosh direct laryngoscope in simulated easy and difficult airways. Methods:We recruited 26 experienced anaesthesia providers into a randomized trial. Each performed tracheal intubation of a Laerdal SimMan ® manikin with each laryngoscope in the following laryngoscopy scenarios: (1) normal airway, (2) cervical spine immobilization, and (3) tongue edema. The intubation times, success rates, number of intubation attempts, laryngoscopic views, and severity of dental compression were recorded. Results:In all scenarios, video laryngoscopes provided better laryngeal exposure than the ML and appeared to produce less dental pressure. In the cervical spine immobilization scenario, D-Blade caused less dental pressure and showed better Cormack-Lehane (CL) classes than the other devices (p<0.001). There were no differences between video laryngoscopes in success of tracheal intubation (p>0.05). The CMAC provided the most rapid intubation. The rate of failure was 19% with ML. In the tongue edema scenario, the CMAC provided the most rapid and successful intubation (p<0.001). There were no differences between video laryngoscopes in laryngoscopic views according to CL classification and dental pressure (p>0.05). The rate of failure was 46% with the ML and 7% with the D-Blade. Conclusion:The CMAC D-Blade caused less dental pressure than the conventional C-MAC and ML in the cervical immobilization scenario. The conventional CMAC performed better than the D-Blade and ML in the tongue edema scenario. These two video laryngoscopes may complement each other in various difficult airway situations.

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“…Hence, laryngoscopy performed using a VL has proven to provide superior views compared to direct laryngoscopy in both normal and difficult intubation situations [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Utilization of C-MAC videolaryngoscopy for direct and indirect assisted endotracheal intubation

Cattano¹,

Ferrario²,

Maddukuri³

et al. 2013

J Anesthesiol Clin Sci

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Background: The experiences of seasoned practitioners with the new C-MAC indirect videolaryngoscope system have shown promising results in the management of difficult airways. However, a comparison of direct and indirect laryngoscopy utilizing the C-MAC system as its own control has not been performed in a cohort of anesthesiologists-in-training. The primary aim was to compare direct and indirect laryngoscopy in terms of intubation time with secondary outcomes including laryngoscopy time and airway view with the same size 3 blade. Methods: The study was registered with www.clinicaltrials.gov (NCT01104090). Oral and written informed consent was obtained from 50 adult patients with BMI < 40 kg/m 2 who required general anesthesia for elective surgery with tracheal tube placement. The patients were randomized to two groups, each receiving two laryngoscopies, n=25 direct-first and n=25 indirect-first. Results: All patients except for one were successfully intubated on the first attempt. The intubation time was 12.3±11.1 sec immediately following videolaryngoscopy (direct laryngoscopy first group) and 9.8±7.1 sec immediately following direct laryngoscopy (videolaryngoscopy first group), p=0.35. The first laryngoscopy time was 8.7±4.7 sec in the direct group and 13.3±10.7 sec in the indirect group, p=0.06. Twenty-percent of direct first cases compared to 0% of indirect first cases showed an improvement in airway view score by at least two classes on the second laryngoscopy, p=0.02. Backward-upward-rightward pressure was used in 36% of direct first and 12% of indirect first patients, p=0.047. Conclusions: This study corroborates previous results on the use of the C-MAC videolaryngoscopy system during endotracheal-assisted intubation. Although there was no difference in intubation time between direct laryngoscopy and videolaryngoscopy, the C-MAC system was found to improve laryngeal views and reduce the number of necessary laryngeal manipulations. A larger randomized study utilizing a similar model is necessary to definitively determine significant clinical results.

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Seeing is believing: the importance of video laryngoscopy in teaching and in managing the difficult airway

Cited by 38 publications

References 12 publications

The use of the BERCI DCI^® Video Laryngoscope for teaching novices direct laryngoscopy and tracheal intubation*

The use of the BERCI DCI^® Video Laryngoscope for teaching novices direct laryngoscopy and tracheal intubation*

Comparison of the C-MAC D-Blade, Conventional C-MAC, and Macintosh Laryngoscopes in Simulated Easy and Difficult Airways

Utilization of C-MAC videolaryngoscopy for direct and indirect assisted endotracheal intubation

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Seeing is believing: the importance of video laryngoscopy in teaching and in managing the difficult airway

Cited by 38 publications

References 12 publications

The use of the BERCI DCI® Video Laryngoscope for teaching novices direct laryngoscopy and tracheal intubation*

The use of the BERCI DCI® Video Laryngoscope for teaching novices direct laryngoscopy and tracheal intubation*

Comparison of the C-MAC D-Blade, Conventional C-MAC, and Macintosh Laryngoscopes in Simulated Easy and Difficult Airways

Utilization of C-MAC videolaryngoscopy for direct and indirect assisted endotracheal intubation

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The use of the BERCI DCI^® Video Laryngoscope for teaching novices direct laryngoscopy and tracheal intubation*

The use of the BERCI DCI^® Video Laryngoscope for teaching novices direct laryngoscopy and tracheal intubation*