Abstract
Objective
The aim of this study was to compare first-attempt and overall success rates and success
rates in relation to placement time among 5 different airway management devices: Storz
CMAC, Glidescope GVL, AirTraq, King LTS-D, and direct laryngoscopy (DL).
Methods
Emergency medical technician basic (EMT-B), EMT-paramedics (EMT-P), and emergency
medicine residents and staff physicians placed each of the 5 devices in a random order
into an AirSim (TruCorp, Belfast, UK) part-task training manikin. The difficult airway
scenario was created by fixing the manikin head to a stationary object and introducing
simulated emesis into the hypopharynx. First-attempt and overall success and success
in relation to placement time were compared. Provider feedback about device performance
was also evaluated.
Results
Ninety-four providers (16 EMT-basics, 54 EMT-paramedics, and 24 emergency department
doctors of medicine) consented to participation. First-attempt and overall success
rates for DL, King LTS-D, GVL, and CMAC were not statistically different. Compared
with DL, the AirTraq was 96% less likely to be placed successfully (odds ratio, 0.04;
95% confidence interval [CI], 0.01-0.14). When time was factored into the model, the
odds of successful placement of the King LTS-D were higher compared with DL (hazard
ratio [HR], 1.80; 95% CI, 1.34-2.42) and lower for GVL (HR, 0.59; 95% CI, 0.44-0.80)
and AirTraq (HR, 0.228; 95% CI, 0.16-0.325). Providers ranked the CMAC first in terms
of performance and preference for use in their practice setting.
Conclusion
Overall success rates for DL, King-LTS-D, and both video laryngoscope systems were
not different. When time was factored into the model, the King LTS-D was more likely
to be placed successfully.
To read this article in full you will need to make a payment
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of Emergency MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Comparison of the Glidescope and Pentax AWS laryngoscopes to Macintosh laryngoscope for use by advanced paramedics in easy and simulated difficult intubation.BMC Emerg Med. 2009; 17: 9
- Comparison of the McGrath Series 5 and Glidescope Ranger with the Macintosh laryngoscope by paramedics.Scand J Trauma Resusc Emerg Med. 2011; 19: 4
- Endotracheal intubation comparing a prototype Storz CMAC and a Glidescope video laryngoscope in a medical transport helicopter—a pilot study.Stud Health Technol Inform. 2009; 142: 37-39
- Endotracheal intubation in a medical transport helicopter—comparing direct laryngoscopy with the prototype Storz CMAC video laryngoscope in a simulated difficult intubation position.Stud Health Technol Inform. 2009; 142: 40-42
- Direct versus video larygoscopic intubation by novice prehospital intubators with and without chest compression: a pilot manikin study.Prehosp Emerg Care. 2011; 15: 98-103
- Comparison of glidescope video laryngoscope and intubating laryngeal mask airway with direct laryngoscopy for endotracheal intubation.Eur J Emerg Med. 2011; 18: 117-120
- Video laryngoscopy with the Macintosh video laryngoscope in simulated prehospital scenarios by paramedic students.Prehosp Emerg Care. 2009; 13: 251-255
- Comparison of prehospital insertion success rates and time to insertion between standard endotracheal intubation and a supraglottic airway.Resuscitation. 2011; 82: 1529-1536
- Alternate airways in the prehospital setting (Resource Document to NAEMSP Position Statement).Prehosp Emerg Care. 2007; 11: 56-61
- Out-of-hospital endotracheal intubation: half empty or half full?.Ann Emerg Med. 2006; 47: 542-544
- Advanced airway management does not improve outcome of out-of-hospital cardiac arrest.Acad Emerg Med. 2010; 17: 926-931
Article Info
Publication History
Published online: January 23, 2013
Accepted:
October 10,
2012
Received in revised form:
October 8,
2012
Received:
July 30,
2012
Footnotes
☆Funding for this study was provided by an internal grant from the HealthPartners Research Foundation (Minneapolis, MN) . Storz CMAC, Glidescope GVL, and AirTraq devices were provided at no cost for use during the simulation scenarios.
☆☆Data from this study were presented in poster abstracts at the January 2011 Annual Meeting of the National Association of EMS Physicians (Bonita Springs, FL) and the June 2011 Annual Meeting of the Society for Academic Emergency Medicine (Boston, MA).
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
