scholarly journals Video laryngoscopy is associated with improved first‐pass intubation success compared with direct laryngoscopy in emergency department trauma patients

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Timmy Li ◽  
Daniel Jafari ◽  
Cristy Meyer ◽  
Ashley Voroba ◽  
Ghania Haddad ◽  
...  
Keyword(s):  
Emergency Department ◽  
Direct Laryngoscopy ◽  
Video Laryngoscopy ◽  
Trauma Patients ◽  
Intubation Success ◽  
First Pass

scholarly journals Does Video Laryngoscopy or Direct Laryngoscopy affect first pass success rates for intubation among Attending and Non-Attending Emergency Physician in the Emergency Department?

2019 ◽  
Author(s):  
Paul Weng Wan ◽  
Zakaria Nur Diana ◽  
Seow Gek Ching ◽  
Wong Evelyn
Keyword(s):  
Emergency Department ◽  
Success Rate ◽  
Direct Laryngoscopy ◽  
Video Laryngoscopy ◽  
Secondary Outcome ◽  
Emergency Physicians ◽  
Success Rates ◽  
Direct Laryngoscope ◽  
First Pass ◽  
Lemon Score

Abstract Background: To our knowledge, there has been no study comparing intubation characteristics between attending and non-attending Emergency Physicians in South-East Asia. We aim to identify whether the use of Direct Laryngoscopy (DL) compared to Video Laryngoscopy (VL) affects first pass success rates between Attending Emergency Physicians (AEP) and Non-Attending Emergency Physicians (NAEP). Materials and Methods: Retrospective analysis of data from 2009 to 2016 in an existing airway registry managed by and academic Emergency Department in Singapore. Primary outcome is first pass success intubation rate. The secondary outcome was first pass success rate for difficult intubations. Difficult intubations were defined as LEMON score of more than 1 or more than 1 attempt at intubation. Results: There were 2909 intubation carried out by emergency physicians in the Emergency Department from 2009 to 2016. AEP conducted 1748 intubations while NAEP conducted 1161 intubations. The first pass success rates for AEP was 84.2% while that for NAEP was 67.4%. 86.2% of intubations by AEP were done with a direct laryngoscope. 89.0% of the intubations by NAEP were done with a direct laryngoscope. 18.9% of intubations by the AEP were difficult compared to 35.2% by the NAEP (p<0.01 95% C.I 13.0%-19.6%). First pass success rate with VL was lower than DL for all intubations (OR 0.66, 95% C.I 0.51-0.84). In the subgroup of difficult intubations, VL did not improve first pass success rate among AEP (OR 0.77, 95% C.I 0.38-1.58) but it did for NAEP (OR 2.46, 95% C.I 0.94-6.45). Conclusion: Our study showed that VL has a poorer first pass success rate for all intubations in general. However, specifically for difficult intubations, VL is associated with improved first pass success rates among NAEP.

scholarly journals Does video laryngoscopy or direct laryngoscopy affect first-pass success rates for intubation among attending and non-attending emergency physicians in the emergency department?

2020 ◽  
pp. 102490792091063
Author(s):  
Wan Paul Weng ◽  
Nur Diana Bte Zakaria ◽  
Seow Gek Ching ◽  
Evelyn Wong
Keyword(s):  
Emergency Department ◽  
Confidence Interval ◽  
Success Rate ◽  
Direct Laryngoscopy ◽  
Video Laryngoscopy ◽  
Secondary Outcome ◽  
Emergency Physicians ◽  
Success Rates ◽  
Mallampati Score ◽  
First Pass

Background: To our knowledge, there has been no study comparing intubation characteristics between attending and non-attending emergency physicians in Southeast Asia. We aim to identify whether the use of direct laryngoscopy compared to video laryngoscopy affects first-pass success rates between attending emergency physicians and non-attending emergency physicians. Materials and methods: Retrospective analysis of data from 2009 to 2016 in an existing airway registry managed by an academic Emergency Department in Singapore. Primary outcome was first-pass success intubation rate. Secondary outcome was first-pass success rate for difficult intubations. Difficult intubations were defined as LEMON (Look externally, Evaluate 3-3-2 rule, Mallampati score, Obstruction, Neck mobility) score of more than 1. Results: There were a total of 2909 intubations. Attending emergency physicians conducted 1748 intubations, while non-attending emergency physicians conducted 1161 intubations. The first-pass success rates for AEP were 84.2% and 67.4% for non-attending emergency physicians. Direct laryngoscopy was used in 86.2% of intubation by attending emergency physicians compared to 89.0% in the intubation by non-attending emergency physicians. Also, 7.6% of intubations by the attending emergency physicians were difficult compared to 8.8% by the non-attending emergency physicians (p = 0.25). Logistic regression of the effect of laryngoscopy device on first-pass success in all intubations showed a negative association with video laryngoscopy (odds ratio, 0.70; 95% confidence interval, 0.56–0.88). In the subgroup of difficult intubations, non-attending emergency physicians are 1.54 times (95% confidence interval, 0.53–4.42) as likely to have first-pass success with video laryngoscopy compared to that with direct laryngoscopy. On the contrary, in the subgroup of difficult intubations, attending emergency physicians are 0.90 times (95% confidence interval, 0.38–2.12) as likely to have first-pass success with video laryngoscopy compared to that with direct laryngoscopy. Conclusion: Our study showed that video laryngoscopy has a lower first-pass success rate for all intubations in general. Intubations performed by attending emergency physicians with direct laryngoscopy were associated with a higher first-pass success rate.

scholarly journals Analysis of tracheal intubation in out-of-hospital helicopter emergency medicine recorded by video laryngoscopy

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Jürgen Knapp ◽  
Bettina Eberle ◽  
Michael Bernhard ◽  
Lorenz Theiler ◽  
Urs Pietsch ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Quality Control ◽  
Tracheal Intubation ◽  
Airway Management ◽  
Success Rate ◽  
Video Laryngoscope ◽  
Solar Irradiation ◽  
Video Laryngoscopy ◽  
Trauma Patients ◽  
Intubation Success

Abstract Background Tracheal intubation remains the gold standard of airway management in emergency medicine and maximizing safety, intubation success, and especially first-pass intubation success (FPS) in these situations is imperative. Methods We conducted a prospective observational study on all 12 helicopter emergency medical service (HEMS) bases of the Swiss Air Rescue, between February 15, 2018, and February 14, 2019. All 428 patients on whom out-of-hospital advanced airway management was performed by the HEMS crew were included. The C-MAC video laryngoscope was used as the primary device for tracheal intubation. Intubation procedures were recorded by the video laryngoscope and precise time points were recorded to verify the time necessary for each attempt and the overall procedure time until successful intubation. The videos were further analysed for problems and complications during airway management by an independent reviewer. Additionally, a questionnaire about the intubation procedure, basic characteristics of the patient, circumstances, environmental factors, and the provider’s level of experience in airway management was filled out. Main outcome measures were FPS of tracheal intubation, overall success rate, overall intubation time, problems and complications of video laryngoscopy. Results FPS rate was 87.6% and overall success rate 98.6%. Success rates, overall time to intubation, and subjective difficulty were not associated to the providers’ expertise in airway management. In patients undergoing CPR FPS was 84.8%, in trauma patients 86.4% and in non-trauma patients 93.3%. FPS in patients with difficult airway characteristics, facial trauma/burns or obesity ranges between 87 and 89%. Performing airway management indoors or inside an ambulance resulted in a significantly higher FPS of 91.1% compared to outdoor locations (p < 0.001). Direct solar irradiation on the screen, fogging of the lens, and blood on the camera significantly impaired FPS. Several issues for further improvements in the use of video laryngoscopy in the out-of-hospital setting and for quality control in airway management were identified. Conclusion Airway management using the C-MAC video laryngoscope with Macintosh blade in a group of operators with mixed experience showed high FPS and overall rates of intubation success. Video recording emergency intubations may improve education and quality control.

scholarly journals Bougie Use and First-Pass Intubation Success in the Emergency Department

2018 ◽  
Vol 71 (3) ◽  
pp. 433-434
Author(s):  
Fu-Shan Xue ◽  
Gui-Zhen Yang ◽  
Ya-Yang Liu ◽  
Hui-Xian Li
Keyword(s):  
Emergency Department ◽  
Intubation Success ◽  
First Pass

Video Laryngoscopy vs Direct Laryngoscopy on Successful First-Pass Orotracheal Intubation Among ICU Patients

JAMA ◽  
2017 ◽  
Vol 317 (5) ◽  
pp. 483 ◽  
Author(s):  
Jean Baptiste Lascarrou ◽  
Julie Boisrame-Helms ◽  
Arthur Bailly ◽  
Aurelie Le Thuaut ◽  
Toufik Kamel ◽  
...  
Keyword(s):  
Direct Laryngoscopy ◽  
Orotracheal Intubation ◽  
Video Laryngoscopy ◽  
Icu Patients ◽  
First Pass
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