Intubation with channeled versus non-channeled video laryngoscopes in simulated difficult airway by junior doctors in an out-of-hospital setting: A crossover manikin study

PLoS One. 2019 Oct 22;14(10):e0224017. doi: 10.1371/journal.pone.0224017. eCollection 2019.

Abstract

Failure to secure the airway is an important cause of morbidity and mortality during resuscitations. We compared the rate of successful intubation of the King Vision™ aBlade™ channeled and non-channeled video laryngoscopes, and McGRATH™ MAC video laryngoscope when used by junior doctors to intubate a simulated difficult airway in an out-of-hospital setting. 105 junior doctors were recruited in a crossover study to perform tracheal intubation with the three video laryngoscopes on a simulated difficult airway using the SimMan® 3G manikin. Primary outcome was the rate of successful intubations. Secondary outcomes were time-to-visualization, time-to-intubation and ease of use. Rates of successful intubations were higher for King Vision channeled and McGrath compared to the King Vision non-channeled (85.7% and 82.9% respectively versus 24.8%; p<0.001). Amongst the participants who had successful intubations, King Vision channeled and McGrath had shorter mean time-to-intubation compared to the King Vision non-channeled (41.3±20.3s and 38.5±18.7s respectively versus 53.8±23.8s, p<0.004;). There was no significant difference in the rate of successful intubation and mean time-to-intubation between King Vision channeled and McGrath. The King Vision channeled and McGrath video laryngoscopes demonstrated superior intubation success rates compared to King Vision non-channeled laryngoscope when used by junior doctors for intubating simulated difficult airway in an out-of-hospital setting. We postulated that the presence of a guidance channel in the King Vision channeled laryngoscope and the familiarity of the blade curvature and handling of the McGrath could have accounted for their improved intubation success rates.

Publication types

  • Comparative Study

MeSH terms

  • Airway Management / methods*
  • Clinical Competence / standards*
  • Cross-Over Studies
  • Equipment Design
  • Humans
  • Intubation, Intratracheal / instrumentation
  • Intubation, Intratracheal / methods
  • Intubation, Intratracheal / standards*
  • Laryngoscopy / instrumentation*
  • Manikins*
  • Medical Staff, Hospital / standards*
  • Video Recording / instrumentation*

Grants and funding

The affliated commercial company ‘RS Anaesthesia & Intensive Care’ was set up by last author R. C. H. Siew RS after completion of study and played no role in the design or conduct of the study. The rest of the authors do not receive salary nor funding from R. C. H. Siew’s private anaesthesia practice. The company did not have any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors have declared that they did not receive any funding nor payment from any of the manufacturers of the laryngoscopes used in this study.