+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Intubation Efficiency and Perceived Ease of Use of Video Laryngoscopy vs Direct Laryngoscopy While Wearing HazMat PPE: A Preliminary High-fidelity Mannequin Study



Intubation Efficiency and Perceived Ease of Use of Video Laryngoscopy vs Direct Laryngoscopy While Wearing HazMat PPE: A Preliminary High-fidelity Mannequin Study



Prehospital and Disaster Medicine 30(3): 259-263



Management of contaminated patients in the decontamination corridor requires the use of hazardous material (HazMat) personal protective equipment (PPE). Previous studies have demonstrated that HazMat PPE may increase the difficulty of airway management. This study compared the efficiency of video laryngoscopy (VL) with traditional direct laryngoscopy (DL) during endotracheal intubation (ETI) while wearing HazMat PPE. Post-graduate year (PGY) 1-3 Emergency Medicine residents were randomized to VL or DL while wearing encapsulating PPE. Video laryngoscopy was performed using the GlideScope Cobalt AVL video laryngoscope. The primary outcome measure was time to successful ETI in a high-fidelity simulation mannequin. Three time points were utilized in the analysis: Time 0 (blade at lips), Time 1 (blade removed from lips after endotracheal tube placement), and Time 2 (bag valve mask [BVM] attached to endotracheal tube). Secondary outcome measures were perceived ease of use and feasibility of VL and DL ETI modalities. Twenty-one of 23 (91.3%) eligible residents participated. Mean time to ETI was 10.0 seconds (SD=5.3 seconds) in the DL group and 7.8 seconds (SD=3.0 seconds) in the VL group (P=.081). Mean times from blade insertion until BVM attachment were 17.4 seconds (SD=6.0 seconds) and 15.6 seconds (SD=4.6 seconds), respectively (P=.30). There were no unsuccessful intubation attempts. Seventeen out of 20 participants (85.0%) perceived VL to be easier to use when performing ETI in PPE. Twelve out of 20 participants (60%) perceived DL to be more feasible in an actual HazMat scenario. The time to successful ETI was not significantly different between VL and DL. Video laryngoscopy had a greater perceived ease of use, but DL was perceived to be more feasible for use in actual HazMat situations. These findings suggest that both DL and VL are reasonable modalities for use in HazMat situations, and the choice of modality could be based on the clinical situation and provider experience.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 058154950

Download citation: RISBibTeXText

PMID: 25959708

DOI: 10.1017/s1049023x15004707


Related references

Comparison of intubation success of video laryngoscopy versus direct laryngoscopy in the difficult airway using high-fidelity simulation. Simulation in Healthcare 4(3): 160-165, 2009

Comparison of Direct Laryngoscopy and Video Laryngoscopy in Intubating a Mannequin: Should Video Laryngoscopy Be Available to Manage Airway Emergencies in the Oral and Maxillofacial Surgery Office?. Journal of Oral and Maxillofacial Surgery 73(10): 1901-1906, 2015

Video Laryngoscopy vs. Direct Laryngoscopy in Teaching Neonatal Endotracheal Intubation: A Simulation-Based Study. Cureus 9(1): E962, 2017

Video laryngoscopy vs. direct laryngoscopy: Which should be chosen for endotracheal intubation during cardiopulmonary resuscitation? A prospective randomized controlled study of experienced intubators. Resuscitation 105: 196-202, 2016

A comparison of video laryngoscopy to direct laryngoscopy for the emergency intubation of trauma patients. World Journal of Surgery 39(3): 782-788, 2015

Comparison of GlideScope Video Laryngoscopy and Direct Laryngoscopy for Tracheal Intubation in Neonates. Anesthesia and Analgesia 129(2): 482-486, 2019

Just-in-Time Video Laryngoscopy Versus Direct Laryngoscopy for Neonatal Intubation. Journal of Perinatal and Neonatal Nursing 30(4): 367-371, 2016

First-Attempt Intubation Success of Video Laryngoscopy in Patients with Anticipated Difficult Direct Laryngoscopy. Anesthesia & Analgesia 122(3): 740-750, 2016

Video laryngoscopy versus direct laryngoscopy for tracheal intubation during in-hospital cardiopulmonary resuscitation. Resuscitation 89: 195-199, 2015

Direct laryngoscopy or C-MAC video laryngoscopy? Routine tracheal intubation in patients undergoing ENT surgery. Der Anaesthesist 59(9): 806-811, 2010

First-Attempt Intubation Success of Video Laryngoscopy in Patients With Anticipated Difficult Direct Laryngoscopy. Survey of Anesthesiology 60(4): 149-150, 2016

Video laryngoscopy versus direct laryngoscopy for first-attempt tracheal intubation in the general ward. Annals of Intensive Care 8(1): 83, 2018

Is video laryngoscopy really superior to direct laryngoscopy for emergency intubation in prehospital trauma patients?. Internal and Emergency Medicine 12(1): 139-140, 2017

A comparison of GlideScope video laryngoscopy versus direct laryngoscopy intubation in the emergency department. Academic Emergency Medicine 16(9): 866-871, 2009

Efficacy of Video Laryngoscopy vs. Direct Laryngoscopy During Urgent Endotracheal Intubation: A Randomized Controlled Trial. Chest Journal 144(4): 580a-580b, 2013