Highlights
- •Glottic visualization improved using videolaryngoscopy (VL), especially among patients with Cormack-Lehane (CL) grades 3 and 4 on direct laryngoscopy (DL).
- •Twenty-four patients had a CL grade 1 to 2 view with DL compared with 45 patients with VL.
- •Of the 25 patients with CL grade 3 and 4 view on DL, 22 were converted to grade 1 and 2 with VL.
- •The overall success rate with VL was 96%, and the first-pass success rate was 71%.
- •VL was functional 100% of the time, with a good or excellent image 98% of the time.
Abstract
Objective
Videolaryngoscopy (VL) in the prehospital setting remains controversial, with conflicting
data on its utility. We compared C-MAC VL (Karl Storz, Tuttlingen, Germany) versus
direct laryngoscopy (DL) in the prehospital setting, recording the grade of the glottic
view, first pass success (FPS), overall success, and equipment functionality.
Methods
We conducted a prospective observational study with a convenience sample of 49 adult
patients who were intubated by flight crew nurses and paramedics using the C-MAC videolaryngoscope
from April to November 2013. We compared Cormack-Lehane (CL) grades of view for DL
and VL, intubation success rates, and equipment functionality.
Results
CL grades 1 or 2 were obtained with 24 patients (49%) with DL and 45 patients (92%)
with VL. Of the 25 patients (51%) who had a CL grade 3 or 4 view on DL, 22 of those
patients (88%) converted to a CL grade 1 or 2 with VL (P < .001). There was an overall success rate of 96% and an FPS rate of 71%. The C-MAC
videolaryngoscope was functional during intubation 100% of the time.
Conclusion
VL improved glottic visualization compared with DL. The FPS and overall intubation
success rates were similar to other published prehospital studies using VL. The C-MAC
provided reliable, high-quality video despite demanding prehospital conditions.
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Article info
Publication history
Published online: December 04, 2020
Identification
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© 2020 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.