title: Comparison of the TruView PCD video laryngoscope and macintosh laryngoscope for pediatric tracheal intubation by novice paramedics: a randomized crossover simulation trial.
abstract: The aim of the present study was to evaluate whether the TruView video laryngoscope (TruView) facilitates pediatric endotracheal intubation (ETI) more quickly and safely than conventional Macintosh laryngoscope (MAC) in three manikin-based airway scenarios. This was a randomized crossover manikin study including 120 novice paramedics. The participants performed tracheal intubations using both TruView and MAC on a pediatric manikin in a control scenario (A), chest compression scenario (B), and chest compression cervical stabilization scenario (C). The sequence of scenarios was randomized. The primary outcome was time to intubation. Secondary outcomes were overall success rates, incidence of dental trauma, and ease of intubation. All intubation attempts were assessed by a trained assistant. The overall success rate was significantly higher with the TruView compared than the MAC in scenario B (100 vs. 81.7 %; p = 0.011) and scenario C (100 vs. 68.3 %; p < 0.001). The intubation time was significantly lower with the TruView than the MAC (18.5 vs. 24.3 s, p = 0.017, for scenario A; 21.6 vs. 25.7 s, p = 0.023, for scenario B; and 28.9 vs. 45.4 s, p < 0.001, for scenario C). Glottic view quality was better with TruView than the MAC in all scenarios, p < 0.001.
  
  
  CONCLUSIONS
  The TruView offers better intubation conditions than the MAC on a pediatric manikin in the control scenario, chest compression scenario, and chest compression scenario with cervical stabilization scenario. The TruView may be used to elevate the epiglottis for orotracheal intubation. Further clinical studies are necessary to confirm these initial positive findings.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT02289872.
  
  
  BACKGROUND
  •Prehospital pediatric intubation using a standard laryngoscope is varied and ranges from 63.4 to 82 %. What is New: •This is the first study showing efficiency of pediatric endotracheal intubation using the TruView PCD by paramedics in tree simulation scenarios. •TruView PCD offers better pediatric intubation conditions than the Macintosh laryngoscope.
authors.affiliation: Department of Emergency Medicine, Medical University of Warsaw, Lindleya 4 Street 02-005, Warsaw, Poland. Lukasz.szarpak@gmail.com.
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Szarpak
authors.affiliation: Department of Anesthesiology, Institute of Cardiology, Warsaw, Poland.|Department of Nephrologic Nursing, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Czyżewski
authors.affiliation: Department of Anesthesiology, Institute of Cardiology, Warsaw, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Kurowski
authors.affiliation: Department of Emergency Medicine, Medical University of Warsaw, Lindleya 4 Street 02-005, Warsaw, Poland.
authors.forename: Zenon
authors.initials: Z
authors.lastname: Truszewski
mesh_terms: D000328:Adult; D000488:Allied Health Personnel / Q000193:education*; D016887:Cardiopulmonary Resuscitation / Q000193:education / Q000379:methods*; D002648:Child; D018592:Cross-Over Studies; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D020704:Laryngoscopes; D008297:Male; D008348:Manikins; D011446:Prospective Studies; D013997:Time Factors; D014741:Video Recording / Q000295:instrumentation*
keywords: Cardiopulmonary resuscitation; Laryngoscope; Macintosh; Paramedic; Simulation; TruView