Factors That Contribute to Provider Decision Between Direct and Video Laryngoscopy in a Helicopter Emergency Medical Services System: A Survey

Abstract

ObjectiveIn caring for critically ill patients in the prehospital setting, rapid, definitive airway management is a high-risk, crucial procedure. All helicopter emergency medical services (HEMS) providers must proficiently and safely perform this procedure. Little information is available about the preference and efficacy of video laryngoscopy (VL) compared with direct laryngoscopy (DL). Additionally, there is a paucity of research investigating which method of intubation is more successful in the HEMS setting. The objective of this study was to delineate factors that contribute to provider decision regarding the method of orotracheal intubation and compare the frequency of use for each method. MethodsAn anonymous online survey was distributed to all providers in a single HEMS program. The survey results were deidentified and blinded to the researchers. ResultsThe survey was sent to 40 HEMS providers; 29 responded, and 119 total intubations were reported. Method familiarity and patient condition were the most commonly cited reasons for choosing both DL and VL for intubation. DL accounted for 15 intubation attempts, whereas 104 attempts were completed by VL. ConclusionFor both laryngoscopy techniques, the top reasons cited for selecting an intubation technique were being comfortable with that technique and patient presentation. Further investigation with chart review would help confirm the reported data.