[The role of videolaryngoscope in endotracheal intubation training programs]

Recai Dagli, Mehmet Canturk, Fatma Celik, Zeynel Abidin Erbesler, Meryem Gurler, Recai Dagli, Mehmet Canturk, Fatma Celik, Zeynel Abidin Erbesler, Meryem Gurler

Abstract

Background: Macintosh laryngoscopes are widely used for endotracheal intubation training of medical students and paramedics whereas there are studies in the literature that supports videolaryngoscopes are superior in endotracheal intubation training. Our aim is to compare the endotracheal intubation time and success rates of videolaryngoscopes and Macintosh laryngoscopes during endotracheal intubation training and to determine the endotracheal intubation performance of the students when they have to use an endotracheal intubation device other than they have used during their education.

Methods: Endotracheal intubation was performed on a human manikin owing a standard respiratory tract by Macintosh laryngoscopes and C-MAC® videolaryngoscope (Karl Storz, Tuttligen, Germany). Eighty paramedic students were randomly allocated to four groups. At the first week of the study 10 endotracheal intubation trials were performed where, Group-MM and Group-MV used Macintosh laryngoscopes; Group-VV and Group-VM used videolaryngoscopes. Four weeks later all groups performed another 10 endotracheal intubation trial where Macintosh laryngoscopes was used in Group-MM and Group-VM and videolaryngoscopes used in Group-VV and Group-MV.

Results: Success rates increased in the last 10 endotracheal intubation attempt in groups MM, VV and MV (p = 0.011; p = 0.021, p = 0.290 respectively) whereas a decrease was observed in group-VM (p = 0.008).

Conclusions: The success rate of endotracheal intubation decreases in paramedic students who used VL during endotracheal intubation education and had to use Macintosh laryngoscopes later. Therefore we believe that solely videolaryngoscopes is not enough in endotracheal intubation training programs.

Keywords: Anestesiologistas; Anesthesiologists; Cardiopulmonary resuscitation; Education; Educação; Emergency staff; Endotracheal intubation; Equipe de emergência; Intubação endotraqueal; Laringoscópios Macintosh; Macintosh laryngoscopes; Paramedic; Paramédico; Reanimação cardiopulmonar; Videolaringoscópios; Videolaryngoscopes.

Copyright © 2018 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Figures

Figure 1
Figure 1
Groups and application scheme (*ML, Macintosh laryngoscope; **VL, videolaryngoscope).

References

    1. Toker K. Visualization of airway. Acta Clin Croat. 2016;55:73–75.
    1. Merli G. Videolaryngoscopy: is it only a change of view? Minerva Anestesiol. 2010;76:569–571.
    1. Wetsch W.A., Carlitscheck M., Spelten O., et al. 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;28:849–858.
    1. Aziz M., Brambrink A. The Storz C-MAC video laryngoscope: description of a new device, case report, and brief case series. J Clin Anesth. 2011;23:149–152.
    1. Gill R.L., Jeffrey A.S., McNarry A.F., et al. The availability of advanced airway equipment and experience with videolaryngoscopy in the UK: two UK surveys. Anesthesiol Res Pract. 2015;2015:152014.
    1. Monsieurs K.G., Nolan J.P., Bossaert L.L., et al. European resuscitation council guidelines for resuscitation 2015: Section 1. Executive summary. Resuscitation. 2015;95:1–80.
    1. Link M.S., Berkow L.C., Kudenchuk P.J., et al. Part 7: adult advanced cardiovascular life support: 2015 American Heart Association Guidelines Update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132:444–464.
    1. Mulcaster J.T., Mills J., Hung O.R., et al. Laryngoscopic intubation: learning and performance. Anesthesiology. 2003;98:23–27.
    1. Dyson K., Bray J., Smith K., et al. Paramedic exposure to out-of-hospital cardiac arrest is rare and declining in Victoria, Australia. Resuscitation. 2015;89:93–98.
    1. Owen H., Plummer J.L. Improving learning of a clinical skill: the first year's experience of teaching endotracheal intubation in a clinical simulation facility. Med Educ. 2002;36:635–642.
    1. Hall R.E., Plant J.R., Bands C.J., et al. Human patient simulation is effective for teaching paramedic students endotracheal intubation. Acad Emerg Med. 2005;12:850–855.
    1. Kaplan M.B., Ward D.S., Berci G. A new video laryngoscope-an aid to intubation and teaching. J Clin Anesth. 2002;14:620–626.
    1. Herbstreit F., Fassbender P., Haberl H., et al. Learning endotracheal intubation using a novel videolaryngoscope improves intubation skills of medical students. Anesth Analg. 2011;113:586–590.
    1. Kim Y.M., Kim J.H., Kang H.G., et al. Tracheal intubation using Macintosh and 2 video laryngoscopes with and without chest compressions. Am J Emerg Med. 2011;29:682–686.
    1. Katz S.H., Falk J.L. Misplaced endotracheal tubes by paramedics in an urban emergency medical services system. Ann Emerg Med. 2001;37:32–37.
    1. Grmec S. Comparison of three different methods to confirm tracheal tube placement in emergency intubation. Intensive Care Med. 2002;28:701–704.
    1. Aziz M.F., Dillman D., Fu R., et al. Comparative effectiveness of the C-MAC video laryngoscope versus direct laryngoscopy in the setting of the predicted difficult airway. Anesthesiology. 2012;116:629–636.
    1. Lee D.H., Han M., An J.Y., et al. Video laryngoscopy versus direct laryngoscopy for tracheal intubation during in-hospital cardiopulmonary resuscitation. Resuscitation. 2015;89:195–199.
    1. Kim J.W., Park S.O., Lee K.R., et al. Video laryngoscopy vs. direct laryngoscopy: Which should be chosen for endotracheal intubation during cardiopulmonary resuscitation? A prospective randomized controlled study of experienced intubators. Resuscitation. 2016;105:196–202.
    1. Schuerner P., Grande B., Piegeler T., et al. Hands-off time for endotracheal intubation during cpr is not altered by the use of the C-MAC video-laryngoscope compared to conventional direct laryngoscopy. A randomized crossover manikin study. PLOS ONE. 2016;11:e0155997.
    1. Saracoglu A., Bezen O., Sengul T., et al. Does video laryngoscopy offer advantages over direct laryngoscopy during cardiopulmonary resuscitation? Turk J Anaesthesiol Reanim. 2015;43:263–268.
    1. Burnett A., Frascone R.J., Wewerka S.S., et al. Comparison of success rates between two video laryngoscope systems used in a prehospital clinical trial. Prehosp Emerg Care. 2014;18:231–238.
    1. Erturk T., Deniz S., Simsek F., et al. Comparison of the Macintosh and Airtraq laryngoscopes in endotracheal intubation success. Turk J Anaesthesiol Reanim. 2015;43:181–187.
    1. Jain D., Dhankar M., Wig J., et al. Comparison of the conventional CMAC and the D-blade CMAC with the direct laryngoscopes in simulated cervical spine injury – a manikin study. Braz J Anesthesiol. 2014;64:269–274.
    1. Zhao H., Feng Y., Zhou Y. Teaching tracheal intubation: Airtraq is superior to Macintosh laryngoscope. BMC Med Educ. 2014;14:144.

Source: PubMed

3
订阅