Laryngoscopic evaluation with the Airway Cam.
OBJECTIVE
The Airway Cam is a head-mounted direct laryngoscopy video system which uses a prismatic sighting system that aligns with the operator's line of sight. This study evaluated intra- and inter-observer consistency in laryngoscopy grading comparing direct laryngoscopy to the laryngoscopy grade obtained with the Airway Cam.


METHODS
Twenty-seven patients receiving a general anesthetic for elective surgery had laryngoscopy performed by an anesthesiologist wearing the Airway Cam. Each video was duplicated, then randomized and reviewed in a blinded fashion by the original laryngoscopist and a second anesthesiologist. Intra- and inter-observer correlations were identified.


RESULTS
There was good intra-observer agreement of the Cormack-Lehane scale between direct laryngoscopy and laryngoscopy recorded with the Airway Cam (kappa = 0.63). The corresponding intra-observer correlation of the percentage of glottic opening score was strong at r = 0.83. There was good inter-observer agreement of the Cormack-Lehane scale between direct laryngoscopy and that observed by the second anesthesiologist during Airway Cam video review (kappa = 0.70). There was moderate correlation of the inter-observer percentage of glottic opening scores (r = 0.73).


CONCLUSIONS
This study validates that the view recorded by the Airway Cam reflects the view of the laryngoscopist. The Airway Cam may introduce an additional level of objectivity into airway management research and teaching.
George
Ronald B
RB
Department of Anesthesia, Room 5452 Halifax Infirmary, QE II Health Sciences Centre, 1796 Summer Street, Halifax, Nova Scotia B3H 3A7, Canada. rbgeorge@eastlink.ca
McKeen
Dolores
D
Law
J Adam
JA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001193:Arytenoid Cartilage / Q000033:anatomy & histology; D005260:Female; D005931:Glottis / Q000033:anatomy & histology; D006801:Humans; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000379:methods*; D007830:Larynx / Q000033:anatomy & histology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D016037:Single-Blind Method; D014741:Video Recording / Q000295:instrumentation*; D014827:Vocal Cords / Q000033:anatomy & histology