scholarly journals Video-assisted instruction improves the success rate for tracheal intubation by novices

2008 ◽  
Vol 101 (4) ◽  
pp. 568-572 ◽  
Author(s):  
K.J. Howard-Quijano ◽  
Y.M. Huang ◽  
R. Matevosian ◽  
M.B. Kaplan ◽  
R.H. Steadman
Keyword(s):  
Tracheal Intubation ◽  
Success Rate ◽  
Video Assisted ◽  
Assisted Instruction

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 Comparison of Airtraq® Laryngoscope, Bonfils Endoscope and Fiberoptic Bronchoscope for Awake Tracheal Intubation: A Randomized, Controlled Trial

2021 ◽  
Vol 9 (2) ◽  
Author(s):  
Köhne W ◽  
◽  
Elfers-Wassenhofen A ◽  
Nosch M ◽  
Groeben H ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Success Rate ◽  
Local Anesthesia ◽  
Difficult Intubation ◽  
Spontaneous Breathing ◽  
Case Reports ◽  
Controlled Trial ◽  
Fiberoptic Intubation ◽  
Randomized Controlled ◽  
Glottic View

Over the last decades several indirect laryngoscopes have been developed to provide a significant better glottic view and improved the success rate in difficult intubations. Some case reports describe the use of indirect laryngoscopes for awake tracheal intubations under preserved spontaneous breathing. However, randomized clinical studies comparing indirect laryngoscopy to the standard of fiberoptic intubation under spontaneous breathing are rare. Therefore, we compared the intubation with the Airtraq® laryngoscope and the Bonfils endoscope, to the standard fiberoptic intubation in patients with an expected difficult intubation under local anesthesia and sedation. 150 patients with an expected difficult intubation were randomized to one of the three devices. All intubation attempts were performed under local anesthesia and sedation. We evaluated success rate, time for intubation and the satisfaction of anesthesiologists and patients. Fiberoptic intubation was significantly more successful (100%) than intubation with an Airtraq® laryngoscope (88%) or the Bonfils endoscope (88%). Time for intubation was quickest with the Airtraq® laryngoscope and significantly shorter than fiberoptic intubation (p=0.044). There was no difference in satisfaction of the anesthesiologists and none of the patients had a negative recall to one of the techniques. An expected difficult intubation can be managed using the Airtraq® laryngoscope or the Bonfils endoscope in 88% and shows the same satisfaction of anesthesiologists and patient. We conclude that these techniques represent an acceptable alternative for an awake tracheal intubation under sedation and preserved spontaneous breathing.

scholarly journals Comparison between use of single lightwand and video laryngoscope-guided lightwand for tracheal intubation in simulated cervical spine-immobilized patients: a single-blind randomized study

2019 ◽  
Vol 47 (11) ◽  
pp. 5632-5642
Author(s):  
Ha Yeon Kim ◽  
Eun Jung Kim ◽  
Hei Jin Yoon ◽  
Byungwoong Ko ◽  
Seung Yeon Choi ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Postoperative Complications ◽  
Tracheal Intubation ◽  
Success Rate ◽  
Randomized Study ◽  
Video Laryngoscope ◽  
Second Grade ◽  
Airway Complications ◽  
Mucosal Bleeding ◽  
Single Blind

Objective This study was performed to compare the use of a video laryngoscope-guided lightwand versus a single lightwand for tracheal intubation performed by non-experts in cervical spine-immobilized patients. Methods In total, 318 patients under general anesthesia were assigned either to the single lightwand group (Group L) or the video laryngoscope-guided lightwand group (Group VL) at a 1:1 ratio. First- or second-grade residents performed tracheal intubation with the assigned device after applying semi-hard fitted cervical collars to the patients. Outcomes, including the success rate and airway complications, were compared between the two groups. Results There were no significant differences in demographics or airway-related characteristics between the two groups. The success rate of intubation on the first attempt was significantly higher in Group VL than in Group L (90% vs. 64%, respectively). Postoperative complications, including oral mucosal bleeding, hoarseness, and sore throat scores at 1 and 24 hours after surgery, were significantly lower in Group VL than in Group L. Conclusions The use of a video laryngoscope-guided lightwand for tracheal intubation can be useful for non-experts who encounter difficult airway situations.

Comparison of Two Techniques for Retrograde Tracheal Intubation in Human Fresh Cadavers

2006 ◽  
Vol 104 (1) ◽  
pp. 48-51 ◽  
Author(s):  
François Lenfant ◽  
Mehdi Benkhadra ◽  
Pierre Trouilloud ◽  
Marc Freysz
Keyword(s):  
Tracheal Intubation ◽  
Endotracheal Tube ◽  
Success Rate ◽  
Guide Wire ◽  
Cricothyroid Membrane ◽  
Simple Modification ◽  
Classic Technique ◽  
Clinical Conditions ◽  
The Impact ◽  
Mean Time

Background During retrograde tracheal intubation, the short distance existing between the cricothyroid membrane and vocal cords may be responsible for accidental extubation. The insertion of a catheter into the trachea before the removal of the guide wire may help to cope with this problem. This work was conducted to study the impact of such a modification on the success rate and the duration of the procedure. Methods Procedures of retrograde tracheal intubation following the classic and modified techniques were randomly performed in cadavers (n = 70). The duration of the procedure from the puncture of the cricothyroid membrane to the inflation of the balloon of the endotracheal tube was measured, and, at the end of the procedure, the position of the endotracheal tube was checked under laryngoscopy. The procedure was considered to have failed if it had taken more than 5 min or when the endotracheal tube was not positioned in the trachea. Results The mean time to achieve tracheal intubation was similar in both groups (123 +/- 51 vs. 127 +/- 41 s; not significant), but intubation failed significantly more frequently with the classic technique (22 vs. 8 failures; P &lt; 0.05). All failures were related to incorrect positioning of the endotracheal tube. In four cases, both techniques failed. Conclusions This efficient, simple modification of the technique significantly increases the success rate of the procedure, without prolonging its duration. These data should be confirmed in clinical conditions but may encourage a larger use of the retrograde technique in cases of difficult intubation.

scholarly journals Comparison of Direct and Indirect Laryngoscopes in Vomitus and Hematemesis Settings: A Randomized Simulation Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Ryosuke Mihara ◽  
Nobuyasu Komasawa ◽  
Sayuri Matsunami ◽  
Toshiaki Minami
Keyword(s):  
Tracheal Intubation ◽  
Success Rate ◽  
Macintosh Laryngoscope ◽  
Intubation Time ◽  
Direct Laryngoscope ◽  
Mcgrath Mac ◽  
Significant Difference ◽  
Intubation Success ◽  
Intubation Success Rate

Background.Videolaryngoscopes may not be useful in the presence of hematemesis or vomitus. We compared the utility of the Macintosh laryngoscope (McL), which is a direct laryngoscope, with that of the Pentax-AWS Airwayscope (AWS) and McGRATH MAC (McGRATH), which are videolaryngoscopes, in simulated hematemesis and vomitus settings.Methods.Seventeen anesthesiologists with more than 1 year of experience performed tracheal intubation on an adult manikin using McL, AWS, and McGRATH under normal, hematemesis, and vomitus simulations.Results.In the normal setting, the intubation success rate was 100% for all three laryngoscopes. In the hematemesis settings, the intubation success rate differed significantly among the three laryngoscopes (P=0.021). In the vomitus settings, all participants succeeded in tracheal intubation with McL or McGRATH, while five failed in the AWS trial with significant difference (P=0.003). The intubation time did not significantly differ in normal settings, while it was significantly longer in the AWS trial compared to McL or McGRATH trial in the hematemesis or vomitus settings (P<0.001, compared to McL or McGRATH in both settings).Conclusion.The performance of McGRATH and McL can be superior to that of AWS for tracheal intubation in vomitus and hematemesis settings in adults.

Blind oral tracheal intubation of rats

1981 ◽  
Vol 51 (5) ◽  
pp. 1355-1356 ◽  
Author(s):  
R. A. Stark ◽  
M. L. Nahrwold ◽  
P. J. Cohen
Keyword(s):  
Tracheal Intubation ◽  
Success Rate ◽  
Endotracheal Intubation ◽  
Direct Vision ◽  
Considerable Time ◽  
Intravenous Catheter ◽  
Anesthetized Rats ◽  
Conventional Methods

Tracheal intubation is often necessary for experiments involving anesthetized rats. Previously described methods for endotracheal intubation have required either a tracheostomy or intubation under direct vision. These techniques require considerable time and skill. Therefore we dissected rats to evaluate the anatomy of the airway. Using these data, we originated a technique for blind oral tracheal intubation using a modified 16-gauge intravenous catheter. The technique has a reasonable success rate and can be performed much more rapidly than conventional methods.

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