title: Impact of Video Laryngoscopy on Advanced Airway Management by Critical Care Transport Paramedics and Nurses Using the CMAC Pocket Monitor.
abstract: Accurate endotracheal intubation for patients in extremis or at risk of physiologic decompensation is the gold standard for emergency medicine. Field intubation is a complex process and time to intubation, number of attempts, and hypoxia have all been shown to correlate with increases in morbidity and mortality. Expanding laryngoscope technology which incorporates active video, in addition to direct laryngoscopy, offers providers improved and varied tools to employ in management of the advanced airway. Over a nine-year period a helicopter emergency medical services team, comprised of a flight paramedic and flight nurse, intended to intubate 790 patients. Comparative data analysis was performed and demonstrated that the introduction of the CMAC video laryngoscope improved nearly every measure of success in airway management. Overall intubation success increased from 94.9% to 99.0%, first pass success rates increased from 75.4% to 94.9%, combined first and second pass success rates increased from 89.2% to 97.4%, and mean number of intubation attempts decreased from 1.33 to 1.08.
authors.affiliation: LifeFlight of Maine, 13 Main Street, Camden, ME 04843, USA ; Laurea University of Applied Sciences, Uudenmaankatu 22, 05800 Hyvinkää, Finland.
authors.forename: Bradley
authors.initials: B
authors.lastname: Boehringer
authors.affiliation: LifeFlight of Maine, 13 Main Street, Camden, ME 04843, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Choate
authors.affiliation: Brigham and Women's Biostatistics Center, 5 Francis Street, Boston, MA 02115, USA.
authors.forename: Shelley
authors.initials: S
authors.lastname: Hurwitz
authors.affiliation: LifeFlight of Maine, 13 Main Street, Camden, ME 04843, USA.
authors.forename: Peter V R
authors.initials: PV
authors.lastname: Tilney
authors.affiliation: LifeFlight of Maine, 13 Main Street, Camden, ME 04843, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Judge
mesh_terms: D000293:Adolescent; D000328:Adult; D000488:Allied Health Personnel; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D005260:Female; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal / Q000379:methods* / Q000706:statistics & numerical data*; D007828:Laryngoscopy / Q000379:methods* / Q000706:statistics & numerical data*; D008297:Male; D009726:Nurses; D012189:Retrospective Studies; D014741:Video Recording; D055815:Young Adult