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?

R Cole Lambert; Christopher Ban; Armando Uribe Rivera; George J Eckert; Deepak G Krishnan; Jeffrey D Bennett

doi:10.1016/j.joms.2015.03.056

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?

J Oral Maxillofac Surg. 2015 Oct;73(10):1901-6. doi: 10.1016/j.joms.2015.03.056. Epub 2015 Apr 10.

Authors

R Cole Lambert¹, Christopher Ban², Armando Uribe Rivera³, George J Eckert⁴, Deepak G Krishnan⁵, Jeffrey D Bennett⁶

Affiliations

¹ Resident, Department of Oral Surgery and Hospital Dentistry, Indiana University School of Dentistry, Indianapolis, IN.
² Resident, Department of Oral and Maxillofacial Surgery, University of Cincinnati Medical Center, Cincinnati, OH.
³ Clinical Research Fellow, Department of Oral and Maxillofacial Surgery, University of Cincinnati Medical Center, Cincinnati, OH.
⁴ Biostatistician Supervisor, Department of Statistics, Indiana University School of Medicine, Indianapolis, IN.
⁵ Associate Professor of Surgery and Residency Program Director, Department of Oral and Maxillofacial Surgery, University of Cincinnati Medical Center, Cincinnati, OH.
⁶ Professor, Department of Oral Surgery and Hospital Dentistry, Indiana University School of Dentistry, Indianapolis, IN. Electronic address: [email protected].

PMID: 25896566
DOI: 10.1016/j.joms.2015.03.056

Abstract

Purpose: Video laryngoscopy (VL) is an innovation in tracheal intubation that could be beneficial in an emergency situation. However, the technique could be detrimental if it prolongs intubation performed by an inexperienced physician. The purpose of this study was to compare direct laryngoscopy (DL) with VL skill for oral and maxillofacial surgery (OMS) residents and practitioners to assess the practicality of recommending the inclusion of VL as a component of OMS emergency airway management.

Materials and methods: To address the research purpose, the authors designed and implemented a randomized crossover study investigating the performance of OMS residents and practitioners to intubate a mannequin using DL versus VL. The predictor variables were the experience level of the participants and their ability to intubate with DL and with VL. The outcome variables were time to view cords, the Cormack-Lehane glottis view achieved, the time to intubate the mannequin, and the total time for performing laryngoscopy and intubation. Comparisons of laryngoscopy and intubation and resident and practitioner experiences were compared using Cox proportional hazards survival analysis.

Results: Data from 22 OMS residents and 26 practitioners were assessed. The comparison outcomes between DL and VL showed that the time to view cords was shorter for VL, the Cormack-Lehane glottis view was better for VL, the time to intubate was shorter for DL, and the total time between techniques was not statistically different. OMS practitioners showed better times than OMS residents and showed adeptness with VL that was comparable to DL.

Conclusion: The combined findings with OMS residents and practitioners showed comparable total intubating times between DL and VL, which is consistent with what has previously been reported with other medical colleagues.

Publication types

Comparative Study
Randomized Controlled Trial

MeSH terms

Cross-Over Studies
Humans
Intubation, Intratracheal / methods*
Laryngoscopy / methods*
Manikins*
Videotape Recording*