title: The C-MAC videolaryngoscope compared with conventional laryngoscopy for rapid sequence intubation at the emergency department: study protocol.
abstract: BACKGROUND
  Especially in the emergency setting, rapid and successful airway management is of major importance. Conventional endotracheal intubation is challenging and requires high level of individual skills and experience. Videolaryngoscopes like the C-MAC are likely to offer better glottis visualization and serve as alternatives to conventional endotracheal intubation. The aim of this study is to compare clinical performance and feasibility of the C-MAC videolaryngoscope compared to conventional endotracheal intubation in the emergency setting.
  
  
  METHODS
  This study is designed as a prospective, patient-blinded, mono-center, randomized cohort study. This study will be performed at the Emergency Department of the University Hospital Zurich, Zurich, Switzerland. All patients transferred to the Emergency Department and requiring emergent endotracheal intubation will be screened. Successful intubation with first intubation attempt will serve as the primary outcome. Time to intubation, intubation attempts, Cormack & Lehane Score, ease of intubation, complications, necessity of using alternate intubation device, maximum drop of saturation, and potential technical problems serve as secondary outcomes.
  
  
  CONCLUSIONS
  In the clinical setting, the ultimate success rate of endotracheal intubation ranges between 97% and 99%. Unexpected difficulties during laryngoscopy and poor glottis visualization occur in up to 9% of all cases. In these cases, videolaryngoscopes may increase success rate of initial intubation attempt and thereby patient safety.
  
  
  BACKGROUND
  www.clinicaltrials.gov (identifier NCT02297113 ).
authors.affiliation: Institute of Anaesthesiology, University and University Hospital Zurich, Zurich, Switzerland. simon.sulser@usz.ch.
authors.forename: Simon
authors.initials: S
authors.lastname: Sulser
authors.affiliation: Institute of Anaesthesiology, University and University Hospital Zurich, Zurich, Switzerland. dirk.ubmann@usz.ch.
authors.forename: Dirk
authors.initials: D
authors.lastname: Ubmann
authors.affiliation: Institute of Anaesthesiology, University and University Hospital Zurich, Zurich, Switzerland. martin.brueesch@usz.ch.
authors.forename: Martin
authors.initials: M
authors.lastname: Brueesch
authors.affiliation: Department of Cardiology, Medical University Vienna, Vienna, Austria. georg.goliasch@meduniwien.ac.at.
authors.forename: Georg
authors.initials: G
authors.lastname: Goliasch
authors.affiliation: Epidemiology, Biostatistics and Prevention Institute, Department of Biostatistics, University of Zurich, Zurich, Switzerland. seifert@ifspm.uzh.ch.
authors.forename: Burkhardt
authors.initials: B
authors.lastname: Seifert
authors.affiliation: Institute of Anaesthesiology, University and University Hospital Zurich, Zurich, Switzerland. donat.spahn@usz.ch.
authors.forename: Donat R
authors.initials: DR
authors.lastname: Spahn
authors.affiliation: Institute of Anaesthesiology, University and University Hospital Zurich, Zurich, Switzerland. kurt.ruetzler@usz.ch.|Outcomes Research Consortium, Cleveland, Ohio, USA. kurt.ruetzler@usz.ch.
authors.forename: Kurt
authors.initials: K
authors.lastname: Ruetzler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013557:Switzerland; D016896:Treatment Outcome