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Correspondence|Articles in Press

Decreased time to intubation by experienced users with a new lens-clearing video laryngoscope in a simulated setting

Published:February 17, 2021DOI:https://doi.org/10.1016/j.ajem.2021.02.028
Decreased time to intubation by experienced users with a new lens-clearing video laryngoscope in a simulated setting
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      Traditionally, direct laryngoscopy (DL) has been the preferred method to perform endotracheal intubations. Over the last two decades, however, video laryngoscopy (VL) has become increasingly prevalent not only in hospital-based environments but increasingly in pre-hospital and combat settings as well [
      • Brown 3rd, C.A.
      • Bair A.E.
      • Pallin D.J.
      • Walls R.M.
      • NEAR III Investigators
      Techniques, success, and adverse events of emergency department adult intubations.
      Ann Emerg Med. 2015; 65 (e1): 363-370
      ,
      • Zaouter C.
      • Calderon J.
      • Hemmerling T.M.
      Videolaryngoscopy as a new standard of care.
      Br J Anaesth. 2015; : 181-183https://doi.org/10.1093/bja/aeu266
      ]. To date, there exist several studies that compare VL to DL in both pre-hospital and hospital settings with varied results, however not all uniformly show any of the VL systems to be superior to DL [
      • Levitan R.M.
      • Heitz J.W.
      • Sweeney M.
      • Cooper R.M.
      The complexities of tracheal intubation with direct laryngoscopy and alternative intubation devices.
      Ann Emerg Med. 2011; : 240-247https://doi.org/10.1016/j.annemergmed.2010.05.035
      ,
      • Jiang J.
      • Ma D.
      • Li B.
      • Yue Y.
      • Xue F.
      Video laryngoscopy does not improve the intubation outcomes in emergency and critical patients--a systematic review and meta-analysis of randomized controlled trials.
      Crit Care. 2017; 21: 288
      ,
      • Healy D.W.
      • Maties O.
      • Hovord D.
      • Kheterpal S.
      A systematic review of the role of videolaryngoscopy in successful orotracheal intubation.
      BMC Anesthesiol. 2012; 12: 32
      ,
      • Nouruzi-Sedeh P.
      • Schumann M.
      • Groeben H.
      Laryngoscopy via macintosh blade versus GlideScopeSuccess rate and time for endotracheal intubation in untrained medical personnel.
      Anesthesiology. 2009; 110: 32-37
      ,
      • Mosier J.M.
      • Whitmore S.P.
      • Bloom J.W.
      • Snyder L.S.
      • Graham L.A.
      • Carr G.E.
      • et al.
      Video laryngoscopy improves intubation success and reduces esophageal intubations compared to direct laryngoscopy in the medical intensive care unit.
      Crit Care. 2013; 17: R237
      ,
      • Lascarrou J.B.
      • Boisrame-Helms J.
      • Bailly A.
      • Le Thuaut A.
      • Kamel T.
      • Mercier E.
      • et al.
      Video laryngoscopy vs direct laryngoscopy on successful first-pass orotracheal intubation among ICU patients.
      JAMA. 2017; : 483https://doi.org/10.1001/jama.2016.20603
      ,
      • Driver B.E.
      • Prekker M.E.
      • Moore J.C.
      • Schick A.L.
      • Reardon R.F.
      • Miner J.R.
      Direct versus video laryngoscopy using the C-MAC for tracheal intubation in the emergency department, a randomized controlled trial.
      Acad Emerg Med. 2016; 23: 433-439
      ]. A known disadvantage of using VL is that the lens may become soiled while in the oropharynx, requiring the user to remove and clean the device [
      • Lockey D.J.
      • Healey B.
      • Crewdson K.
      • Chalk G.
      • Weaver A.E.
      • Davies G.E.
      Advanced airway management is necessary in prehospital trauma patients.
      Br J Anaesth. 2015; : 657-662https://doi.org/10.1093/bja/aeu412
      ,
      • Naito H.
      • Guyette F.X.
      • Martin-Gill C.
      • Callaway C.W.
      Video laryngoscopic techniques associated with intubation success in a helicopter emergency medical service system.
      Prehosp Emerg Care. 2016; 20: 333-342
      ,
      • Lockey D.J.
      • Avery P.
      • Harris T.
      • Davies G.E.
      • Lossius H.M.
      A prospective study of physician pre-hospital anaesthesia in trauma patients: the rate of oesophageal intubation, gross airway contamination and the value of the “quick look” airway assessment.
      Scand J Trauma Resuscit Emerg Med. 2013; https://doi.org/10.1186/1757-7241-21-s1-s26
      ,
      • Wong E.
      • Ng Y.-Y.
      The difficult airway in the emergency department.
      Int J Emerg Med. 2008; 1: 107-111
      ]. This may prolong intubation times and result in increased attempts and desaturation [
      • Martin L.D.
      • Mhyre J.M.
      • Shanks A.M.
      • Tremper K.K.
      • Kheterpal S.
      3,423 emergency tracheal intubations at a university hospital airway outcomes and complications.
      Anesthesiology. 2011; 114: 42-48
      ,
      • Mort T.C.
      Emergency tracheal intubation: complications associated with repeated laryngoscopic attempts.
      Anesth Analg. 2004; 99 (table of contents): 607-613
      ,
      • Schwartz D.E.
      • Matthay M.A.
      • Cohen N.H.
      Death and other complications of emergency airway management in critically ill adults. A prospective investigation of 297 tracheal intubations.
      Anesthesiology. 1995; 82: 367-376
      ,
      • Hasegawa K.
      • Shigemitsu K.
      • Hagiwara Y.
      • Chiba T.
      • Watase H.
      • Brown 3rd, C.A.
      • et al.
      Association between repeated intubation attempts and adverse events in emergency departments: an analysis of a multicenter prospective observational study.
      Ann Emerg Med. 2012; 60 (e2): 749-754
      ].

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      References

        • Brown 3rd, C.A.
        • Bair A.E.
        • Pallin D.J.
        • Walls R.M.
        • NEAR III Investigators
        Techniques, success, and adverse events of emergency department adult intubations.
        Ann Emerg Med. 2015; 65 (e1): 363-370
        View in Article
        • Zaouter C.
        • Calderon J.
        • Hemmerling T.M.
        Videolaryngoscopy as a new standard of care.
        Br J Anaesth. 2015; : 181-183https://doi.org/10.1093/bja/aeu266
        View in Article
        • Levitan R.M.
        • Heitz J.W.
        • Sweeney M.
        • Cooper R.M.
        The complexities of tracheal intubation with direct laryngoscopy and alternative intubation devices.
        Ann Emerg Med. 2011; : 240-247https://doi.org/10.1016/j.annemergmed.2010.05.035
        View in Article
        • Jiang J.
        • Ma D.
        • Li B.
        • Yue Y.
        • Xue F.
        Video laryngoscopy does not improve the intubation outcomes in emergency and critical patients--a systematic review and meta-analysis of randomized controlled trials.
        Crit Care. 2017; 21: 288
        View in Article
        • Healy D.W.
        • Maties O.
        • Hovord D.
        • Kheterpal S.
        A systematic review of the role of videolaryngoscopy in successful orotracheal intubation.
        BMC Anesthesiol. 2012; 12: 32
        View in Article
        • Nouruzi-Sedeh P.
        • Schumann M.
        • Groeben H.
        Laryngoscopy via macintosh blade versus GlideScopeSuccess rate and time for endotracheal intubation in untrained medical personnel.
        Anesthesiology. 2009; 110: 32-37
        View in Article
        • Mosier J.M.
        • Whitmore S.P.
        • Bloom J.W.
        • Snyder L.S.
        • Graham L.A.
        • Carr G.E.
        • et al.
        Video laryngoscopy improves intubation success and reduces esophageal intubations compared to direct laryngoscopy in the medical intensive care unit.
        Crit Care. 2013; 17: R237
        View in Article
        • Lascarrou J.B.
        • Boisrame-Helms J.
        • Bailly A.
        • Le Thuaut A.
        • Kamel T.
        • Mercier E.
        • et al.
        Video laryngoscopy vs direct laryngoscopy on successful first-pass orotracheal intubation among ICU patients.
        JAMA. 2017; : 483https://doi.org/10.1001/jama.2016.20603
        View in Article
        • Driver B.E.
        • Prekker M.E.
        • Moore J.C.
        • Schick A.L.
        • Reardon R.F.
        • Miner J.R.
        Direct versus video laryngoscopy using the C-MAC for tracheal intubation in the emergency department, a randomized controlled trial.
        Acad Emerg Med. 2016; 23: 433-439
        View in Article
        • Lockey D.J.
        • Healey B.
        • Crewdson K.
        • Chalk G.
        • Weaver A.E.
        • Davies G.E.
        Advanced airway management is necessary in prehospital trauma patients.
        Br J Anaesth. 2015; : 657-662https://doi.org/10.1093/bja/aeu412
        View in Article
        • Naito H.
        • Guyette F.X.
        • Martin-Gill C.
        • Callaway C.W.
        Video laryngoscopic techniques associated with intubation success in a helicopter emergency medical service system.
        Prehosp Emerg Care. 2016; 20: 333-342
        View in Article
        • Lockey D.J.
        • Avery P.
        • Harris T.
        • Davies G.E.
        • Lossius H.M.
        A prospective study of physician pre-hospital anaesthesia in trauma patients: the rate of oesophageal intubation, gross airway contamination and the value of the “quick look” airway assessment.
        Scand J Trauma Resuscit Emerg Med. 2013; https://doi.org/10.1186/1757-7241-21-s1-s26
        View in Article
        • Wong E.
        • Ng Y.-Y.
        The difficult airway in the emergency department.
        Int J Emerg Med. 2008; 1: 107-111
        View in Article
        • Martin L.D.
        • Mhyre J.M.
        • Shanks A.M.
        • Tremper K.K.
        • Kheterpal S.
        3,423 emergency tracheal intubations at a university hospital airway outcomes and complications.
        Anesthesiology. 2011; 114: 42-48
        View in Article
        • Mort T.C.
        Emergency tracheal intubation: complications associated with repeated laryngoscopic attempts.
        Anesth Analg. 2004; 99 (table of contents): 607-613
        View in Article
        • Schwartz D.E.
        • Matthay M.A.
        • Cohen N.H.
        Death and other complications of emergency airway management in critically ill adults. A prospective investigation of 297 tracheal intubations.
        Anesthesiology. 1995; 82: 367-376
        View in Article
        • Hasegawa K.
        • Shigemitsu K.
        • Hagiwara Y.
        • Chiba T.
        • Watase H.
        • Brown 3rd, C.A.
        • et al.
        Association between repeated intubation attempts and adverse events in emergency departments: an analysis of a multicenter prospective observational study.
        Ann Emerg Med. 2012; 60 (e2): 749-754
        View in Article
        • Farmery A.D.
        Simulating hypoxia and modelling the airway.
        Anaesthesia. 2011; 66: 11-18
        View in Article
        • Davis D.P.
        • Hwang J.Q.
        • Dunford J.V.
        Rate of decline in oxygen saturation at various pulse oximetry values with prehospital rapid sequence intubation.
        Prehosp Emerg Care. 2008; 12: 46-51
        View in Article

      Article Info

      Publication History

      Published online: February 17, 2021
      Accepted: February 12, 2021
      Received in revised form: February 12, 2021
      Received: February 2, 2021

      Publication stage

      In Press Journal Pre-Proof

      Identification

      DOI: https://doi.org/10.1016/j.ajem.2021.02.028

      Copyright

      © 2021 Elsevier Inc. All rights reserved.

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