Tracheal Intubation in a Mannikin: Comparison of the Belscope With the Macintosh Laryngoscope

Hodges, U.M.; O’Flaherty, David; Adams, A. P.

doi:10.1093/bja/71.6.905

Cited by 20 publications

(12 citation statements)

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“…They also play a core role in teaching skills for basic life support. Their use for teaching intubation and investigating new equipment and techniques is also well established [27,28]. Howells et al [29] described the use of an early manikin for training in tracheal intubation.…”

Section: Didactic Teachingmentioning

confidence: 99%

“…They found that despite its limited realism it was a useful training tool for the novice. Others have adjusted the manikins to simulate difficult laryngoscopy [27,28] or have suggested their use in other than the supine position [30], thus increasing their training potential.…”

Section: Didactic Teachingmentioning

confidence: 99%

“…These are important for assessing trainees' knowledge and judgement but do not test for competency in practical skills, which is essential for successful clinical performance. The presence of learning curves for practical skills in anaesthesia is well recognised [27,28,30]. From these, estimates of the number of procedures that must be performed by a trainee in order to reach an acceptable success rate can be produced.…”

Section: Learning Curves and Assessmentmentioning

confidence: 99%

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Training in airway management

2002

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Section: Didactic Teachingmentioning

confidence: 99%

Section: Didactic Teachingmentioning

confidence: 99%

Section: Learning Curves and Assessmentmentioning

confidence: 99%

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Training in airway management

2002

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“…This was due to the high tracheal intubation success rates with all devices in our study. One must consider the fact that the success rates for paramedical personnel performing endotracheal intubations using a Macintosh laryngoscope in similar studies are variable [16,17]. The reason for this variability may be attributed to different study settings.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the McGrath® Series 5 and GlideScope® Ranger with the Macintosh laryngoscope by paramedics

Piepho

Weinert

Heid

et al. 2011

Scand J Trauma Resusc Emerg Med

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BackgroundOut-of-hospital endotracheal intubation performed by paramedics using the Macintosh blade for direct laryngoscopy is associated with a high incidence of complications. The novel technique of video laryngoscopy has been shown to improve glottic view and intubation success in the operating room. The aim of this study was to compare glottic view, time of intubation and success rate of the McGrath® Series 5 and GlideScope® Ranger video laryngoscopes with the Macintosh laryngoscope by paramedics.MethodsThirty paramedics performed six intubations in a randomised order with all three laryngoscopes in an airway simulator with a normal airway. Subsequently, every participant performed one intubation attempt with each device in the same manikin with simulated cervical spine rigidity using a cervical collar. Glottic view, time until visualisation of the glottis and time until first ventilation were evaluated.ResultsTime until first ventilation was equivalent after three intubations in the first scenario. In the scenario with decreased cervical motion, the time until first ventilation was longer using the McGrath® compared to the GlideScope® and AMacintosh (p < 0.01). The success rate for endotracheal intubation was similar for all three devices. Glottic view was only improved using the McGrath® device (p < 0.001) compared to using the Macintosh blade.ConclusionsThe learning curve for video laryngoscopy in paramedics was steep in this study. However, these data do not support prehospital use of the McGrath® and GlideScope® devices by paramedics.

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“…9,11,12 Although the use of a mannequin does not fully replicate intubating conditions in patients, a simulated grade III in an intubation mannequin allows training for and evaluation of intubation techniques in situations that frequently lead to intubation difficulties in humans.…”

Section: Discussionmentioning

confidence: 99%

difficult airway management: comparison of the bullard laryngoscope with the video-optical intubation stylet

Weiß

Schwarz

Gerber

2000

Can J Anesth/J Can Anesth

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Purpose: To evaluate, whether the video-optical intubation stylet (VOIS) was more successful for difficult tracheal intubation than the Bullard laryngoscope (BL). Methods: An intubation mannequin head was modified so that, using a Macintosh blade size 3, only the epiglottis was visible at direct laryngoscopy, representing a grade III laryngoscopic view. Forty anesthesiologists attempted tracheal intubation using each technique. Tracheal intubation with the Bullard laryngoscope was performed using the attached non-malleable intubating stylet preloaded with an endotracheal tube. The video-optical intubation stylet inserted into an endotracheal tube was used with direct laryngoscopy. During conventional laryngoscopy, the video-view from the stylet tip allowed the tracheal tube to be guided behind the epiglottis into the trachea. Ten attempts with each technique were performed by each anesthesiologist in randomized order. Intubation time, and failed intubation (> 60 sec / esophageal intubation) were recorded. The operators assessed the degree of difficulty of each method using a Likert-scale.Results: Mean intubation time (19.2 ± 4.5 sec for the BL and 18.8 ± 4.6 sec for the VOIS) was almost the identical. The video-optical intubation stylet was associated with fewer failed intubations (8 vs 41; P < 0.005) and had a lower degree of difficulty (1.7 ± 0.65 for the VOIS and 2.6 ± 0.74 for the BL; P < 0.0001). No correlation was found between the anesthesiologist's experience and mean intubation time, estimated degree of difficulty or number of unsuccessful intubation. Conclusion: The video-optical intubation stylet was a more effective and simpler intubation device to facilitate difficult tracheal intubation than the Bullard laryngoscope.

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Tracheal Intubation in a Mannikin: Comparison of the Belscope With the Macintosh Laryngoscope

Cited by 20 publications

References 0 publications

Training in airway management

Training in airway management

Comparison of the McGrath® Series 5 and GlideScope® Ranger with the Macintosh laryngoscope by paramedics

difficult airway management: comparison of the bullard laryngoscope with the video-optical intubation stylet

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