title: Inexpensive video-laryngoscopy guided intubation using a personal computer: initial experience of a novel technique.
abstract: Video-laryngoscopy may provide an enhanced view of laryngeal structures compared to direct visualization. Commercial video-laryngoscopes are often expensive, limiting its adoption for routine use. We describe our initial experience using an inexpensive custom made device. Patients >15 years age, were randomly chosen, after informed consent, for video-laryngoscopy. A custom device easily assembled using an USB endoscopic camera, a conventional Macintosh laryngoscope blade size 3 or 4, and a personal computer was used. Patients with Mallampati class 1-3 were chosen. Video-laryngoscopy was recorded and reviewed. Twenty-four patients aged 16-68 years, of mean weight 58.46 ± 12.54 (40-86) kg were studied. The glottis could be visualized and intubation could be performed in all patients with 22/24 patients on first attempt. Mean duration of laryngoscopy was 22.17 ± 12.78 (7-59) s. Time taken for intubation, was mean of 28.58 ± 21.01 (9-89) s. Three patients with anticipated difficult airways could be intubated on the first attempt. Minor blood staining of the airway was seen in the video in two patients. Cormack-Lehane laryngoscopy grade visualized was 1 in 9/24, 2 in 15/24 patients. Percentage of glottic opening score was 62.29 ± 28.40 (20-100) %. Real-time video could be captured in all cases. The custom-made, inexpensive, video-laryngoscopy device is safe and reliable for clinical use. Real-time visualization and endotracheal intubation were successful in all patients, including those with anticipated difficult airway. Further, this device helps in archiving the video of intubation.
authors.affiliation: Kasturba Medical College, Manipal University, Manipal, 576104, India, johngeorgedon@gmail.com.
authors.forename: John George
authors.initials: JG
authors.lastname: Karippacheril
authors.forename: Goneppanavar
authors.initials: G
authors.lastname: Umesh
authors.forename: Venkateswaran
authors.initials: V
authors.lastname: Ramkumar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D007194:India; D007442:Intubation, Intratracheal / Q000191:economics / Q000295:instrumentation* / Q000379:methods; D020704:Laryngoscopes / Q000191:economics; D007828:Laryngoscopy / Q000191:economics / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014741:Video Recording / Q000191:economics / Q000295:instrumentation*; D055815:Young Adult