title: A comparison of a traditional endotracheal tube versus ETView SL in endotracheal intubation during different emergency conditions: A randomized, crossover cadaver trial.
abstract: BACKGROUND
  Airway management is a crucial skill essential to paramedics and personnel working in Emergency Medical Services and Emergency Departments: Lack of practice, a difficult airway, or a trauma situation may limit the ability of paramedics to perform direct laryngoscopy during cardiopulmonary resuscitation. Videoscope devices are alternatives for airway management in these situations. The ETView VivaSight SL (ETView; ETView Ltd., Misgav, Israel) is a new, single-lumen airway tube with an integrated high-resolution imaging camera. To assess if the ETView VivaSight SL can be a superior alternative to a standard endotracheal tube for intubation in an adult cadaver model, both during and without simulated CPR.
  
  
  METHODS
  ETView VivaSight SL tube was investigated via an interventional, randomized, crossover, cadaver study. A total of 52 paramedics participated in the intubation of human cadavers in three different scenarios: a normal airway at rest without concomitant chest compression (CC) (scenario A), a normal airway with uninterrupted CC (scenario B) and manual in-line stabilization (scenario C). Time and rate of success for intubation, the glottic view scale, and ease-of-use of ETView vs. sETT intubation were assessed for each emergency scenario.
  
  
  RESULTS
  The median time to intubation using ETView vs. sETT was compared for each of the aforementioned scenarios. For scenario A, time to first ventilation was achieved fastest for ETView, 19.5 [IQR, 16.5-22] sec, when compared to that of sETT at 21.5 [IQR, 20-25] sec (p = .013). In scenario B, the time for intubation using ETView was 21 [IQR, 18.5-24.5] sec (p < .001) and sETT was 27 [IQR, 24.5-31.5] sec. Time to first ventilation for scenario C was 23.5 [IQR, 19-25.5] sec for the ETView and 42.5 [IQR, 35-49.5] sec for sETT.
  
  
  CONCLUSIONS
  In normal airways and situations with continuous chest compressions, the success rate for intubation of cadavers and the time to ventilation were improved with the ETView. The time to glottis view, tube insertion, and cuff block were all found to be shorter with the ETView.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT02733536.
authors.affiliation: Department of Emergency Medicine Department of Forensic Medicine, Medical University of Warsaw, Warsaw Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria Outcomes Research Consortium Departments of Outcomes Research and General Anesthesiology, Cleveland Clinic, Cleveland, OH.
authors.forename: Zenon
authors.initials: Z
authors.lastname: Truszewski
authors.forename: Paweł
authors.initials: P
authors.lastname: Krajewski
authors.forename: Marcin
authors.initials: M
authors.lastname: Fudalej
authors.forename: Jacek
authors.initials: J
authors.lastname: Smereka
authors.forename: Michael
authors.initials: M
authors.lastname: Frass
authors.forename: Oliver
authors.initials: O
authors.lastname: Robak
authors.forename: Bianka
authors.initials: B
authors.lastname: Nguyen
authors.forename: Kurt
authors.initials: K
authors.lastname: Ruetzler
authors.forename: Lukasz
authors.initials: L
authors.lastname: Szarpak
mesh_terms: D000328:Adult; D002102:Cadaver; D018592:Cross-Over Studies; D004638:Emergency Treatment; D004867:Equipment Design; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D011897:Random Allocation