title: A comparison of the GlideScope video laryngoscope and standard direct laryngoscopy in children with immobilized cervical spine.
abstract: OBJECTIVE
  Airway management in children with cervical spine may make direct laryngoscopy difficult. Video laryngoscopy is an alternative to direct laryngoscopy. The GlideScope video laryngoscope, successfully used in expected and unexpected difficult pediatric airway situations, has not been studied so far in children with cervical spine immobilization.
  
  
  METHODS
  A total of 23 children underwent laryngoscopy with manual cervical spine immobilization using the GlideScope and a direct laryngoscope (Miller 1 or Macintosh 2 blade). Percentage of glottis opening score, Cormack-Lehane score, and time to best view were recorded.
  
  
  RESULTS
  Percentage of glottis opening score using the GlideScope was 50% (1%-87%) and 90% (60%-100%) using direct laryngoscopy (P < 0.001). Cormack-Lehane score using the GlideScope was 1 (1-2.7) and 1 (1-1) in direct laryngoscopy (P < 0.001). Time to best view with the GlideScope was 21 seconds (12.2-28 seconds) and 7 seconds (6-8.7 seconds) in direct laryngoscopy (P < 0.05). Data are presented as median and interquartile range and analyzed using paired t test.
  
  
  CONCLUSIONS
  In simulated difficult pediatric airway, using the GlideScope resulted in a significantly declined view to the glottic entrance. This result is in contrast to studies in children with difficult airway anatomy due to an anterior larynx, where the GlideScope resulted in improved views.
authors.affiliation: Department of Pediatric Anesthesia, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada. arnim.vlatten@iwk.nshealth.ca
authors.forename: Arnim
authors.initials: A
authors.lastname: Vlatten
authors.forename: Sharon
authors.initials: S
authors.lastname: Litz
authors.forename: Brian
authors.initials: B
authors.lastname: MacManus
authors.forename: Sebastian
authors.initials: S
authors.lastname: Launcelott
authors.forename: Chris
authors.initials: C
authors.lastname: Soder
mesh_terms: D058109:Airway Management / Q000295:instrumentation / Q000379:methods*; D002574:Cervical Vertebrae; D002648:Child; D002675:Child, Preschool; D005931:Glottis / Q000033:anatomy & histology; D006801:Humans; D007103:Immobilization; D007442:Intubation, Intratracheal / Q000379:methods; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000379:methods; D008020:Life Support Care; D008991:Monitoring, Physiologic; D019838:Neck Injuries / Q000628:therapy; D010092:Oximetry; D013124:Spinal Injuries / Q000628:therapy; D016683:Supine Position; D015599:Trauma Severity Indices; D020535:Video-Assisted Surgery / Q000295:instrumentation*