• J Emerg Med · Jun 2021

    Randomized Controlled Trial

    Video Laryngoscopy Improves Intubation Times With Level C Personal Protective Equipment in Novice Physicians: A Randomized Cross-Over Manikin Study.

    • Ioannis Pantazopoulos, Konstantina Kolonia, Eleni Laou, Maria Mermiri, Vasiliki Tsolaki, Anastasios Koutsovasilis, Georgios Zakynthinos, Konstantinos Gourgoulianis, Eleni Arnaoutoglou, and Athanasios Chalkias.
    • Department of Emergency Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
    • J Emerg Med. 2021 Jun 1; 60 (6): 764-771.

    BackgroundThe use of video laryngoscopes by novice physicians may improve first-pass success rates compared with direct laryngoscopy.ObjectiveThe aim of the present study was to assess whether time to intubation, number of laryngoscopy attempts, and first-pass success rate during laryngoscopy with the video laryngoscope or conventional Macintosh laryngoscope are affected by personal protective equipment (PPE) donning.MethodsSeventy inexperienced physicians were randomly assigned to video laryngoscope or Macintosh groups and were instructed to perform intubation with both devices on a manikin, using PPE or a standard uniform. The primary outcomes were insertion time, number of laryngoscopy attempts, and first-pass success rates for each device with or without donning PPE.ResultsIn the Macintosh group, significantly less time was needed for the first successful intubation without PPE vs. with PPE (12.17 ± 3.69 s vs. 24.07 ± 5.09 s, respectively; p < 0.0001). On the other hand, such difference was not observed in the video laryngoscope group (14.99 ± 3.01 s vs. 14.01 ± 3.35 s, respectively; p = 0.07). With PPE, the first-pass success rate was significantly higher in the video laryngoscope group [41 (58.6%) vs. 66 (94.3%), p < 0.001]. The use of the video laryngoscope resulted in a significant decrease in insertion time compared with the Macintosh blade (14.01 ± 3.35 s vs. 24.07 ± 5.09 s, respectively; p < 0.0001).ConclusionFirst-pass success and insertion time with the video laryngoscope were not affected by PPE donning. However, both were negatively affected with the Macintosh laryngoscope.Copyright © 2021 Elsevier Inc. All rights reserved.

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