PMID- 27797983
OWN - NLM
STAT- MEDLINE
DCOM- 20171120
LR  - 20191210
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 6
IP  - 10
DP  - 2016 Oct 24
TI  - Efficacy of various types of laryngoscope (direct, Pentax Airway Scope and 
      GlideScope) for endotracheal intubation in various cervical immobilisation 
      scenarios: a randomised cross-over simulation study.
PG  - e011089
LID - 10.1136/bmjopen-2016-011089 [doi]
LID - e011089
AB  - OBJECTIVE: To compare the efficacy of direct laryngoscopy (DL), Pentax Airway 
      Scope (PAWS) and GlideScope video laryngoscope (GVL) systems for endotracheal 
      intubation (ETI) in various cervical immobilisation scenarios: manual in-line 
      stabilisation (MILS), Philadelphia neck collar (PNC) (moderate limit of mouth 
      opening) and Stifneck collar (SNC) (severe limit of mouth opening). DESIGN: 
      Randomised cross-over simulation study. SETTING AND PARTICIPANTS: 35 physicians 
      who had >30 successful ETI experiences at a tertiary hospital in Seoul, Korea. 
      PRIMARY AND SECONDARY OUTCOME MEASURES: Participants performed ETI using PAWS, 
      GVL and DL randomly in simulated MILS, PNC and SNC scenarios in our simulation 
      centre. The end points were successful ETI and the time to complete ETI. In 
      addition, modified Cormack-Lehane (CL) classification and pressure to teeth were 
      recorded. RESULTS: In MILS, there were no significant differences in the rate of 
      success of ETI between the three devices: 33/35(94.3%) for DL vs 32/35(91.4%) for 
      GVL vs 35/35(100.0%) for PAWS; p=0.230). PAWS achieved successful ETI more 
      quickly (19.8 s) than DL (29.6 s) and GVL (35.4 s). For the PNC scenario, a 
      higher rate of successful ETI was achieved with GVL 33/35 (94.3%) than PAWS 29/35 
      (82.9%) or DL 25/35 (71.4%) (p=0.040). For the SNC scenario, a higher rate of 
      successful ETI was achieved with GVL 28/35(80.0%) than with DL 14/35(40.0%) and 
      PAWS 7/35(20.0%) (p<0.001). For the PNC and SNC scenarios, GVL provided a 
      relatively good view of the glottis, but a frequent pressure to teeth occurred. 
      CONCLUSIONS: All three devices are suitable for ETI in MILS. DL is not suitable 
      in both neck collar scenarios. PAWS showed faster intubations in MILS, but was 
      not suitable in the SNC scenario. GVL is most suitable in all cervical 
      immobilisation scenarios, but may cause pressure to teeth more frequently.
CI  - Published by the BMJ Publishing Group Limited. For permission to use (where not 
      already granted under a licence) please go to 
      http://www.bmj.com/company/products-services/rights-and-licensing/.
FAU - Kim, Jong Won
AU  - Kim JW
AD  - Department of Emergency Medicine, Konkuk University Medical Center, Konkuk 
      University School of Medicine, Seoul, Korea.
FAU - Lee, Kyeong Ryong
AU  - Lee KR
AD  - Department of Emergency Medicine, Konkuk University Medical Center, Konkuk 
      University School of Medicine, Seoul, Korea.
FAU - Hong, Dae Young
AU  - Hong DY
AD  - Department of Emergency Medicine, Konkuk University Medical Center, Konkuk 
      University School of Medicine, Seoul, Korea.
FAU - Baek, Kwang Je
AU  - Baek KJ
AD  - Department of Emergency Medicine, Konkuk University Medical Center, Konkuk 
      University School of Medicine, Seoul, Korea.
FAU - Lee, Young Hwan
AU  - Lee YH
AD  - Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym 
      University, Anyang-si, Korea.
FAU - Park, Sang O
AU  - Park SO
AD  - Department of Emergency Medicine, Konkuk University Medical Center, Konkuk 
      University School of Medicine, Seoul, Korea.
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
DEP - 20161024
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - Adult
MH  - Cross-Over Studies
MH  - Female
MH  - Humans
MH  - Immobilization
MH  - Intubation, Intratracheal/*methods
MH  - *Laryngoscopes/adverse effects
MH  - Laryngoscopy/adverse effects/*instrumentation
MH  - Male
MH  - Manikins
MH  - *Neck
MH  - Pressure
MH  - Tooth
PMC - PMC5093373
OTO - NOTNLM
OT  - cervical stabilization
OT  - direct laryngoscopy
OT  - tracheal intubation
OT  - video laryngoscopy
COIS- Conflicts of Interest: None declared.
EDAT- 2016/11/01 06:00
MHDA- 2017/11/29 06:00
PMCR- 2016/10/24
CRDT- 2016/11/01 06:00
PHST- 2016/11/01 06:00 [pubmed]
PHST- 2017/11/29 06:00 [medline]
PHST- 2016/11/01 06:00 [entrez]
PHST- 2016/10/24 00:00 [pmc-release]
AID - bmjopen-2016-011089 [pii]
AID - 10.1136/bmjopen-2016-011089 [doi]
PST - epublish
SO  - BMJ Open. 2016 Oct 24;6(10):e011089. doi: 10.1136/bmjopen-2016-011089.