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Comparison of Intubation Success Rate and Times Required for Intubation by Glottic Exposure Methods with Glidescope(R)
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Hyung Seo Jang, Jun Bum Park, Jae Hoon Oh, Chang Sun Kim, Hyuk Joong Choi, Bo Seung Kang, Tae Ho Lim, Hyung Goo Kang
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Korean J Crit Care Med. 2013;28(4):241-246.
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DOI: https://doi.org/10.4266/kjccm.2013.28.4.241
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 Abstract
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- BACKGROUND
The glottis can be exposed by a Glidescope(R) during endotracheal intubation using either the epiglottis or valleculae elevation method. We compared the epiglottis and valleculae elevation methods for endotracheal intubations performed with a Glidescope(R) using differences in success rate, time spent for tracheal intubation and percent of glottic opening.
METHODS
Forty medical students without experience using a Glidescope(R) participated in this prospective, randomized study in which they intubated a tracheal tube into a manikin. All participants performed tracheal intubation using the 2 forementioned methods. Twenty students exposed the vocal cord by placing the blade tip in the valleculae (valleculae elevation method; VEM). The other 20 students directly elevated the epiglottis with the blade (epiglottis elevation method; EEM). We separated intubating time into 3 parts: turnaround time to exposing the vocal cord, tube passing time and first ventilating time.
RESULTS
The success rate of tracheal intubation using VEM (86.7%, 104/120) was higher than that using EEM (65.8%, 79/120) (p < 0.001). VEM resulted in a lower total intubation time (VEM vs. EEM, 23.5 +/- 5.3 vs. 29.0 +/- 8.7, p = 0.001). The key factor of this difference was the tube passing time (VEM vs. EEM, 7.4 +/- 2.5 vs. 12.8 +/- 7.4, p < 0.001).
CONCLUSIONS
Exposing the vocal cord by using VEM during tracheal intubation with a Glidescope(R) can increase the success rate of tracheal intubation and shorten the time of endotracheal intubation in novices.
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Comparison of Cervical Spine Movement by Airway Equipment during Orotracheal Intubation: A Manikin Pilot Study
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Sang Hyun Lee, Hyuk Choong Choi, Hyung Goo Kang, Bo Seung Kang, Tai Ho Lim
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Korean J Crit Care Med. 2010;25(4):230-234.
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DOI: https://doi.org/10.4266/kjccm.2010.25.4.230
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Abstract
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- BACKGROUND
In patients with limited cervical spine movement, equipment for orotracheal intubation should achieve sufficient laryngeal exposure with the least cervical spine movement. This study was designed to compare movement of the cervical spine during the orotracheal intubation with various intubating equipment.
METHODS
Twelve emergency physicians & residents with a total experience of >50 cases of endotracheal intubation in two emergency centers were assigned to perform orotracheal intubation with four different airway devices, including the Macintosh laryngoscope (ML), DCI video laryngoscope (DCI), Airway Scope (AWS) and Levitan Scope (LS), using the same manikin (Ambu(R) airway management trainer) in random sequences. Movement of the C-spine was examined by measuring the angle formed by two lines which are parallel to the anterior surface of the C2 and C7 vertebrae bodies. The angle was measured when Cormack-Lehane grade II glottis exposure was achieved during intubation.
RESULTS
Mean cervical spine movements were 37.6 +/- 9.2degrees, 32.2 +/- 14.2degrees, 32.2 +/- 6.45degrees and 17.4 +/- 10.0degrees with the ML, DCI (p = 0.347), AWS (p = 0.094), and LS (p < 0.001), respectively, compared to that of ML. Cervical spine movement by LS was 54% less than that by ML. LS produced less cervical spine movement in comparison to DCI (p = 0.013) and AWS (p = 0.001).
CONCLUSIONS
The Levitan Scope produced less movement of the cervical spine when compared to the Macintosh laryngoscope, DCI video-laryngoscope and Airway Scope during orotracheal intubation in a single airway training manikin model.
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