title: Transfer of skills and comparison of performance between king vision® video laryngoscope and macintosh blade following an AHA airway management course.
abstract: To potentially optimize intubation skill teaching in an American Heart Association® Airway Management Course® for novices, we investigated the transfer of skills from video laryngoscopy to direct laryngoscopy and vice versa using King Vision® and Macintosh blade laryngoscopes respectively.
  
  
  
  Ninety volunteers (medical students, residents and staff physicians) without prior intubation experience were randomized into three groups to receive intubation training with either King Vision® or Macintosh blade or both. Afterwards they attempted intubation on two human cadavers with both tools. The primary outcome was skill transfer from video laryngoscopy to direct laryngoscopy assessed by first attempt success rates within 60 s. Secondary outcomes were skill transfer in the opposite direction, the efficacy of teaching both tools, and the success rates and esophageal intubation rates of Macintosh blade versus King Vision®.
  
  
  
  Performance with the Macintosh blade was identical following training with either Macintosh blade or King Vision® (unadjusted odds ratio [OR] 1.09, 95% confidence interval [95% CI] 0.5-2.6). Performance with the King Vision® was significantly better in the group that was trained on it (OR 2.7, 95% CI 1.2-5.9). Success rate within 60 s with Macintosh blade was 48% compared to 52% with King Vision® (OR 0.85, 95% CI 0.4-2.0). Rate of esophageal intubations with Macintosh blade was significantly higher (17% versus 4%, OR 5.0, 95% CI 1.1-23).
  
  
  
  We found better skill transfer from King Vision® to Macintosh blade than vice versa and fewer esophageal intubations with video laryngoscopy. For global skill improvement in an airway management course for novices, teaching only video laryngoscopy may be sufficient. However, success rates were low for both devices.
authors.affiliation: Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Lukas E
authors.initials: LE
authors.lastname: Wolf
authors.affiliation: Division of Anesthesia, Balgrist University Hospital, Zurich, Switzerland.
authors.forename: José A
authors.initials: JA
authors.lastname: Aguirre
authors.affiliation: Division of Anesthesia, Balgrist University Hospital, Zurich, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Vogt
authors.affiliation: Department of Anesthesiology, Schulthess Clinic, Schulthess Clinic, Lengghalde 2, 8008, Zurich, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Keller
authors.affiliation: Division of Anesthesia, Balgrist University Hospital, Zurich, Switzerland.
authors.forename: Alain
authors.initials: A
authors.lastname: Borgeat
authors.affiliation: Department of Anesthesiology, Schulthess Clinic, Schulthess Clinic, Lengghalde 2, 8008, Zurich, Switzerland. heinz.bruppacher@kws.ch.|SkillsLab, Deanery, Faculty of Medicine, University of Zurich, Zurich, Switzerland. heinz.bruppacher@kws.ch.
authors.forename: Heinz R
authors.initials: HR
authors.lastname: Bruppacher
mesh_terms: D058109:Airway Management / Q000295:instrumentation*; D002102:Cadaver; D002983:Clinical Competence; D005260:Female; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000193:education* / Q000295:instrumentation; D008297:Male; D014163:Transfer, Psychology; D014741:Video Recording
keywords: Advanced life support; Airway management; Endotracheal intubation; Medical education; Resuscitation; Video laryngoscopy