A prospective cohort evaluation of the McGrath™ MAC videolaryngoscope in a series of 979 cases

Abstract

BackgroundEvidence favouring the effectiveness of videolaryngoscopes over conventional direct laryngoscopy for facilitating successful tracheal intubation has been growing. However, to choose between different devices, clinicians need to know how individual devices perform outside of carefully controlled clinical trials. AimTo evaluate the effectiveness of the McGrath MAC videolaryngoscope as it was introduced into clinical practice. MethodsCohort evaluation of McGrath MAC videolaryngoscope use in clinical practice by voluntary completion of an evaluation form over a two-year period. ResultsIn a total of 979 cases, tracheal intubation was successful in 955/979 (97.5%), with first pass success achieved in 785/955 (82.2%). Most tracheal intubations (964/979, 80.1%) were performed during ‘office hours’ (Monday to Friday 0800-1800). Senior anaesthetists conducted 423/970 (43.6%) of intubations. There were 24/979 (2.5%) failed intubations, with consultants or senior anaesthetists conducting laryngoscopy in the majority of these; in 16/22 failed intubations, a grade I or II glottic view was obtained on the videolaryngoscope screen. Of the 20 anaesthetists involved as intubators, 14 had used the device fewer than 50 times. ConclusionOur historical results demonstrate the effectiveness and feasibility of using the McGrath MAC videolaryngoscope to facilitate tracheal intubation in clinical practice. However, we believe the most important finding was the number of “easy” grade I and II glottic views on videolaryngoscopy where tracheal intubation was not achieved. Our experience and the evidence suggest that in order to fully realise the numerous benefits of videolaryngoscopy, the introduction of formal teaching and instruction by trained trainers is essential.