Video laryngoscopy improves endotracheal intubation training for novices

Aseri, Salmin; Ahmad, Hafiz Badaruddin; Vallance, Hilary

doi:10.1093/bja/aev189

Cited by 10 publications

(13 citation statements)

References 2 publications

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“…VLs are often part of standard operating procedures (SOPs) for managing expected and unexpected difficult airways and clinicians should be capable of using them effectively. Therefore, VL should be used as often as possible to improve experience with the devices [27]. We were able to show a better view of the glottis in a simulated difficult airway by using indirect VL.…”

Section: Discussionmentioning

confidence: 99%

Prospective Trial to Compare Direct and Indirect Laryngoscopy Using C-MAC PM® with Macintosh Blade and D-Blade® in a Simulated Difficult Airway

Raimann

Dietze

Cuca

et al. 2019

Emergency Medicine International

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Objective. Evaluation of C-MAC PM® in combination with a standard Macintosh blade size 3 in direct and indirect laryngoscopy and D-Blade® in indirect laryngoscopy in a simulated difficult airway. Primary outcome was defined as the best view of the glottic structures. Secondary endpoints were subjective evaluation and assessment of the intubation process. Methods. Prospective monocentric, observational study on 48 adult patients without predictors for difficult laryngoscopy/tracheal intubation undergoing orthopedic surgery. Every participant preoperatively received a cervical collar to simulate a difficult airway. Direct and indirect laryngoscopy w/o the BURP maneuver with a standard Macintosh blade and indirect laryngoscopy w/o the BURP maneuver using D-Blade® were performed to evaluate if blade geometry and the BURP maneuver improve the glottic view as measured by the Cormack-Lehane score. Results. Using a C-MAC PM® laryngoscope, D-Blade® yielded improved glottic views compared with the Macintosh blade used with either the direct or indirect technique. Changing from direct laryngoscopy using a Macintosh blade to indirect videolaryngoscopy using C-MAC PM® with D-Blade® improved the Cormack-Lehane score from IIb, III, or IV to I or II in 31 cases. Conclusion. The combination of C-MAC PM® and D-Blade® significantly enhances the view of the glottis compared to direct laryngoscopy with a Macintosh blade in patients with a simulated difficult airway. Trial Registration Number. This trial is registered under number NCT03403946.

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Section: Discussionmentioning

confidence: 99%

Prospective Trial to Compare Direct and Indirect Laryngoscopy Using C-MAC PM® with Macintosh Blade and D-Blade® in a Simulated Difficult Airway

Raimann

Dietze

Cuca

et al. 2019

Emergency Medicine International

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“…6 Several editorialists have called for videolaryngoscopy to be a first-line technique for airway management. [7][8][9][10] Importantly, the role of videolaryngoscopy in difficult intubation has recently been recognized in the DAS 2015 guidelines, which recommend that all anaesthetists are trained in videolaryngoscopy and that all anaesthetists have immediate access to a videolaryngoscope at all times. 2 Videolaryngoscopy has been recommended for intubating obese patients, 3 11 12 a group known to have a higher risk of complications associated with airway management.…”

Section: Benefits Of Videolaryngoscopymentioning

confidence: 99%

“…When the trainer can observe the larynx on a screen while the trainee performs laryngoscopy, the trainer can help the trainee to optimize the blade position and advise the trainee on where to place the tracheal tube by pointing out necessary landmarks on the screen. 9 As the view of the larynx can be seen by trainee and trainer, and the technique can be optimized in real time, it is more likely that a trainee will be able to complete an intubation themselves without the trainer taking over. 23 This is especially useful for rapid sequence inductions and in patients at risk of hypoxia.…”

Section: Benefits Of Videolaryngoscopymentioning

confidence: 99%

“…23 This is especially useful for rapid sequence inductions and in patients at risk of hypoxia. 9 Whether the trainee is 'allowed' to see the screen or simply to use the videolaryngoscope for direct laryngoscopy (with reference to the screen only if difficulties are encountered) can be decided according to training aims. Five studies have now demonstrated that training novice intubators in direct laryngoscopy is more effective when the trainee uses a videolaryngoscope rather than a standard Macintosh laryngoscope.…”

Section: Benefits Of Videolaryngoscopymentioning

confidence: 99%

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Seeing is believing: getting the best out of videolaryngoscopy

Kelly

Cook

2016

British Journal of Anaesthesia

104

101

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Complications secondary to airway management in anaesthesia are relatively rare but when they do occur, the causal and contributory factors are often attributed to human error related to inadequate training and poor judgement by the anaesthetist. 1 These complications continue to occur despite competencybased medical education curricula and detailed practice guidelines. One criticism of competency-based medical education is that it applies primarily to trainees and focuses too much on the Editorials | i13

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“…Video laryngoscopes improve training for novices by allowing real-time instruction and provides an avenue for documentation of airway anatomy for future airway management, both of which can improve patient safety and some authors advocate for video laryngoscopy to be the standard of care. [100][101][102] Based on the available evidence, video laryngoscopy should be considered as the initial device especially in patients with difficult airway characteristics, to maximize the likelihood of first attempt success. A point of emphasis in the NAP4 report was the lack of availability and use of flexible fiberoptic devices for intubation in patients with challenging airways.…”

Section: Device Selectionmentioning

confidence: 99%

Strategies to improve first attempt success at intubation in critically ill patients

Natt

Malo

Hypes

et al. 2016

British Journal of Anaesthesia

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Tracheal intubation in critically ill patients is a high-risk procedure. The risk of complications increases with repeated or prolonged attempts, making expedient first attempt success the goal for airway management in these patients. Patient-related factors often make visualization of the airway and placement of the tracheal tube difficult. Physiologic derangements reduce the patient's tolerance for repeated or prolonged attempts at laryngoscopy and, as a result, hypoxaemia and haemodynamic deterioration are common complications. Operator-related factors such as experience, device selection, and pharmacologic choices affect the odds of a successful intubation on the first attempt. This review will discuss the 'difficult airway' in critically ill patients and highlight recent advances in airway management that have been shown to improve first attempt success and decrease adverse events associated with the intubation of critically ill patients.

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Video laryngoscopy improves endotracheal intubation training for novices

Cited by 10 publications

References 2 publications

Prospective Trial to Compare Direct and Indirect Laryngoscopy Using C-MAC PM® with Macintosh Blade and D-Blade® in a Simulated Difficult Airway

Prospective Trial to Compare Direct and Indirect Laryngoscopy Using C-MAC PM® with Macintosh Blade and D-Blade® in a Simulated Difficult Airway

Seeing is believing: getting the best out of videolaryngoscopy

Strategies to improve first attempt success at intubation in critically ill patients

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