title: Assessing the efficacy of video versus direct laryngoscopy through retrospective comparison of 436 emergency intubation cases.
abstract: Video laryngoscopy has become a common practice for tracheal intubations. However, information on its efficacy in emergency intubations is minimal. The external video monitor may act as a means for assistance by present staff, heighten teaching ability, and improve intubation outcomes. We conducted a retrospective review consisting of 436 patients requiring emergency intubation outside the operating room to evaluate the application of a C-MAC video laryngoscope for emergency intubation(s). Nine cases were removed, 315 underwent direct laryngoscopy, 73 underwent video laryngoscopy, and 39 underwent both methods. The C-MAC laryngoscope provided a significantly better visualization of the glottis (p = 0.02). The C-MAC also provided successful intubation on the first attempt in 82 % of the 39 direct laryngoscopy cases subsequently intubated with the C-MAC. The presence of the attending anesthesiologist (while the resident intubates) had no effect on complication rates; the number of attempts required and the grade view obtained were nonsignificant (p = 0.91 and p = 0.34, respectively). Overall, use of the C-MAC video laryngoscope provided a better view of the airway structures during an emergency intubation. The success of the C-MAC laryngoscope in intubation after failed direct laryngoscopy suggests the importance of the video laryngoscope as the primary intubation approach during an emergency intubation.
authors.affiliation: Department of Anesthesiology, University of Nebraska Medical Center, 984455 Nebraska Medical Center, Omaha, NE, 68198-4455, USA, benjamen.jones@unmc.edu.
authors.forename: Benjamen M
authors.initials: BM
authors.lastname: Jones
authors.forename: Ankit
authors.initials: A
authors.lastname: Agrawal
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Schulte
mesh_terms: D000328:Adult; D015331:Cohort Studies; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007828:Laryngoscopy / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D020535:Video-Assisted Surgery / Q000379:methods*