Patients with trauma present unique airway management concerns. Conventional oral
intubation with manual in-line stabilization (MILS) is still the most effective approach
for early control of the airway in trauma
[
[1]
]. However, there are situations in which access to the patient is difficult and direct
viewing of the airways is impossible
[
2
,
3
]. Such a situation might be encountered when a patient requires intubation when trapped
in a vehicle
[
[4]
]. In such cases, alternative methods of endotracheal intubation can be used, including
videolaryngoscopy or video tubes, ie, the ETView VivaSight-SL (ETView Ltd., Misgav,
Israel).
TableData from intubation with access from the back seat of the car scenario
| Parameter assessed | MAC | ETView | P |
|---|---|---|---|
| Time to intubation (s) | 49 (41–63) | 22.9 (20.4–26) | <.001 |
| Overall success rate (%) | 45 (100%) | 45 (100%) | NS |
| Success rate of first attempt (%) | 30 (66.7%) | 45 (100%) | 0.003 |
| Dental compression | |||
| N | - | 42 (93.3%) | |
| 1 | 33 (73.4%) | 3 (6.7%) | <.001 |
| 2 | 11 (24.4%) | - | |
| 3 | 1 (2.2%) | - | |
| Ease of intubation | 6.5 (5–7) | 2.5 (2–3.5) | <.001 |
Data reported as median (IQR) or number (%); NS = Not Statistically Significant; MAC = Macintosh laryngoscope; ETView = ETView VivaSight-SL.
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References
- Airway management in adults after cervical spine trauma.Anesthesiology. 2006; 104: 1293-1318
- Endotracheal Intubation In pediatric patients using video laryngoscopy: An evidence-based review.Pediatr Emerg Med Pract. 2015 Aug; 12: 1-22
- Use of the GlideScope®-ranger for pre-hospital intubations by anaesthesia trained emergency physicians - an observational study.BMC Emerg Med. 2016; 16: 8https://doi.org/10.1186/s12873-016-0069-2
- Success rates and endotracheal tube insertion times of experienced emergency physicians using five video laryngoscopes: a randomised trial in a simulated trapped car accident victim.Eur J Anaesthesiol. 2011; 28: 849-858https://doi.org/10.1097/EJA.0b013e32834c7c7f
Truszewski Z, Szarpak L, Smereka J, Kurowski A, Evrin T, Czyzewski L. Comparison of the VivaSight™ single lumen endotracheal tube and the Macintosh laryngoscope for emergency intubation by experienced paramedics in a standardized airway manikin with restricted access. A randomized, crossover trial. Am J Emerg Med 2016. http://dx.doi.org/10.1016/j.ajem.2016.02.054 [pii: S0735-6757(16)00161-3].
Article Info
Publication History
Published online: March 01, 2016
Accepted:
February 27,
2016
Received:
February 24,
2016
Footnotes
☆Source of support: No sources of financial and material support to be declared.
Identification
Copyright
© 2016 Published by Elsevier Inc.
