Abstract
Videolaryngoscopes may reduce cervical spine movement during tracheal intubation in patients with neck trauma. This manikin study aimed to compare the performance of disposable non-channeled and channeled blades of the King Vision™ videolaryngoscope in simulated cervical spine injury. Fifty-eight anesthesiologists in training intubated the TruMan manikin with the neck immobilized using each blade in a randomized order. The primary outcome was the time needed for tracheal intubation, secondary aims included total success rate, the time required for visualization of the larynx, number of attempts, view of the vocal cords, and subjective assessment of both methods. Intubation time with the channeled blade was shorter, with a median time of 13 s (IQR 9–19) vs. 23 s (14.5–37.5), p < 0.001, while times to visualization of the larynx were similar in both groups (p = 0.54). Success rates were similar in both groups, but intubation with the non-channeled blade required more attempts (1.52 vs. 1.05; p < 0.001). The participants scored the intubation features of the channeled blade significantly higher, while visualization features were scored similarly in both groups. Both blades of the King Vision™ videolaryngoscope are reliable intubation devices in a simulated cervical spine injury in a manikin model when inserted by non-experienced operators. The channeled blade allowed faster intubation of the trachea.
Highlights
Videolaryngoscopy-guided tracheal intubation is gradually moving from operating rooms to emergency medicine departments and to the out-of-hospital setting [1]
Patients with potential cervical spine trauma have a higher incidence of difficult intubation due to neck immobility caused by inline stabilization or the application of a cervical collar, which may lead to restricted mouth opening [2]
Several studies have compared the performance of King VisionTM videolaryngoscopes with standard blades, data comparing the performance of disposable non-channeled versus channeled videolaryngoscope blades are not available
Summary
Videolaryngoscopy-guided tracheal intubation is gradually moving from operating rooms to emergency medicine departments and to the out-of-hospital setting [1]. The most recent, second generation of the device (Ambu, Ballerup, Denmark) is characterized by the reusable body (containing the monitor and flexible optical stylet) and by its use of interchangeable disposable plastic channeled and non-channeled blades [7]. Several studies have compared the performance of King VisionTM videolaryngoscopes with standard blades, data comparing the performance of disposable non-channeled versus channeled videolaryngoscope blades are not available. The aim of this simulation study was to compare the performance of single-use non-channeled standard aBladeTM and channeled aBladeTM blades of the KingVisionTM videolaryngoscope in a simulated cervical spine injury when inserted by relatively inexperienced operators
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