In emergency medicine, endotracheal intubation is the gold standard for airway management. First-pass intubation success is beneficial because it secures the patient airway more quickly and avoids complications associated with repeated attempts, such as bleeding and swelling of soft tissue. The key to first-pass success is the ability to visualize the laryngeal inlet. Visualization can be accomplished using traditional direct laryngoscopy or video laryngoscopy. The purpose of our study was to compare the rate of successful first-pass endotracheal intubations using a video laryngoscope with that using a direct visualization laryngoscope in a prehospital emergency setting.
We retrospectively reviewed data that had been prospectively collected in our emergency department regarding patients who underwent endotracheal intubation performed by personnel from a single local ambulance service from January 1, 2014, through December 31, 2015.
One hundred eighty-one patients were intubated using video laryngoscopy and 115 using direct visualization laryngoscopy. The first-pass endotracheal intubation success rate using video laryngoscopy was 12.6% higher than with direct laryngoscopy.
This retrospective study shows that video laryngoscopy had a higher first-pass success rate than direct laryngoscopy. This is promising because decreasing failure rates provide better patient outcomes.
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- Advances in prehospital airway management.Int J Crit Illn Inj Sci. 2014; 4: 57-64
- The importance of first pass success when performing orotracheal intubation in the emergency department.Acad Emerg Med. 2013; 20: 71-78
- Timing of intubation and clinical outcomes in adults with acute respiratory distress syndrome.Crit Care Med. 2016; 44: 120-129
- The first shot is often the best shot: first-pass intubation success in emergency airway management.Anesth Analg. 2015; 121: 1389-1393
- Video-assisted instruction improves the success rate for tracheal intubation by novices.Br J Anaesth. 2008; 101: 568-572
- Comparison of traditional versus video laryngoscopy in out-of-hospital tracheal intubation.Prehosp Emerg Care. 2010; 14: 278-282
- Direct versus video laryngoscopic intubation by novice prehospital intubators with and without chest compressions: a pilot manikin study.Prehosp Emerg Care. 2011; 15: 98-103
- Videolaryngoscopy and indirect intubating aids in airway management.in: Khan ZH Airway Management. Springer, Cham, Switzerland2014: 33-70
- A comparison of video laryngoscopy to direct laryngoscopy for the emergency intubation of trauma patients.World J Surg. 2015; 39: 782-788
- Comparison of the glidescope, the McGrath, the airtraq and the macintosh laryngoscopes in simulated difficult airways*.Anaesthesia. 2008; 63: 1358-1364
- Comparison of the laryngeal view during intubation using airtraq and macintosh laryngoscopes in patients with cervical spine immobilization and mouth opening limitation.Korean J Anesthesiol. 2010; 59: 314-318
- Evaluation of the bullard, GlideScope, viewmax, and macintosh laryngoscopes using a cadaver model to simulate the difficult airway.J Clin Anesth. 2011; 23: 27-34
- Comparison of macintosh, truview EVO2, glidescope, and airwayscope laryngoscope use in patients with cervical spine immobilization.Br J Anaesth. 2008; 101: 723-730
- Comparison of the airway scope and macintosh laryngoscope with in-line cervical stabilization by the semisolid neck collar: manikin study.J Trauma. 2010; 68: 363-366
Published online: July 11, 2019
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