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Ulus Travma Acil Cerrahi Derg · Apr 2023
Randomized Controlled TrialImpact of VieScope® on first-attempt success during simulated COVID-19 patients intubation: A randomized cross-over simulation trial.
- Togay Evrin, Leyla Öztürk Sönmez, Lezsek Gadek, Michal Pruc, Alla Navolokina, Wojciech Wieczorek, Maciej Cyran, Jacek Smereka, and Gül Deniz Özkan.
- Department of Emergency Medicine, Ufuk University Faculty of Medicine, Dr. Rıdvan Ege Training and Research Hospital, Ankara-Türkiye.
- Ulus Travma Acil Cerrahi Derg. 2023 Apr 1; 29 (4): 463470463-470.
BackgroundThe purpose of our study was to determine the efficacy of intubation with VieScope® and Macintosh laryngoscope in different scenarios of simulated COVID-19 patients by paramedics wearing personal protective equipment (PPE) for aerosol gener-ating procedures (AGPs).MethodsStudy was designed as a prospective, observational, randomized, crossover simulation trial. 37 paramedics took part in the study. They performed endotracheal intubation (ETI) of a person suspected of COVID-19. Intubation was performed using VieS-cope® and Macintosh laryngoscopes in two research scenarios: Scenario A - normal airway and Scenario B - difficult airway. Both the order of participants and the methods of intubation were random.ResultsIn Scenario A, time to intubation using VieScope® and Macintosh laryngoscope amounted to 35.3 (IQR; 32-40) seconds and 35.8 (IQR: 30-40)s, respectively. Nearly all participants performed ETI successfully both with VieScope® and Macintosh laryngo-scope (100% vs. 94.6%). In scenario B, intubation with the VieScope®, compared to the Macintosh laryngoscope, was associated with a shorter intubation time (p<0.001), a higher success rate of the first intubation attempt (p<0.001), a better visualization degree glottis (p=0.012) and ease of intubation (p<0.001).ConclusionOur analysis suggests that the use of a VieScope® compared to Macintosh laryngoscope in difficult airway intuba-tion performed by paramedics wearing PPE-AGP is associated with shorter intubation times, greater intubation efficiency as well as better visualization of the glottis. Additional clinical trials are necessary to confirm the obtained results.
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