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A Comparison of Paramedic First Pass Endotracheal Intubation Success Rate of the VividTrac VT-A 100, GlideScope Ranger, and Direct Laryngoscopy Under Simulated Prehospital Cervical Spinal Immobilization Conditions in a Cadaveric Model

Published online by Cambridge University Press:  15 August 2017

Ryan Hodnick ,
Tony Zitek ,
Kellen Galster ,
Stephen Johnson ,
Bryan Bledsoe  and
Daniel Ebbs
Ryan Hodnick*
Affiliation:
Santa Fe Fire Department, Santa Fe, New MexicoUSA Santa Fe County Fire EMS, Santa Fe, New MexicoUSA Arteria Fire Department, Artesia, New MexicoUSA Carlsbad Fire Department, Carlsbad, New MexicoUSA TriState CareFlight, Bullhead City, ArizonaUSA MedFlight, Albuquerque, New MexicoUSA University of Nevada Department of Emergency Medicine, Las Vegas, NevadaUSA
Tony Zitek
Affiliation:
University of Nevada Department of Emergency Medicine, Las Vegas, NevadaUSA
Kellen Galster
Affiliation:
University of Nevada Department of Emergency Medicine, Las Vegas, NevadaUSA
Stephen Johnson
Affiliation:
Medic West Ambulance, Las Vegas, NevadaUSA
Bryan Bledsoe
Affiliation:
University of Nevada Department of Emergency Medicine, Las Vegas, NevadaUSA Medic West Ambulance, Las Vegas, NevadaUSA
Daniel Ebbs
Affiliation:
A.T. Still School of Osteopathic Medicine, Mesa, ArizonaUSA
*
Correspondence: Ryan Hodnick, DO, NREMT-P University of Nevada School of Medicine Department of Emergency Medicine 901 Rancho Lane, Suite 135 Las Vegas, Nevada 89106 USA E-mail: lasvegas.em@gmail.com
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Abstract

Objective

The primary goal of this study was to compare paramedic first pass success rate between two different video laryngoscopes and direct laryngoscopy (DL) under simulated prehospital conditions in a cadaveric model.

Methods

This was a non-randomized, group-controlled trial in which five non-embalmed, non-frozen cadavers were intubated under prehospital spinal immobilization conditions using DL and with both the GlideScope Ranger (GL; Verathon Inc, Bothell, Washington USA) and the VividTrac VT-A100 (VT; Vivid Medical, Palo Alto, California USA). Participants had to intubate each cadaver with each of the three devices (DL, GL, or VT) in a randomly assigned order. Paramedics were given 31 seconds for an intubation attempt and a maximum of three attempts per device to successfully intubate each cadaver. Confirmation of successful endotracheal intubation (ETI) was confirmed by one of the six on-site physicians.

Results

Successful ETI within three attempts across all devices occurred 99.5% of the time overall and individually 98.5% of the time for VT, 100.0% of the time for GL, and 100.0% of the time for DL. First pass success overall was 64.4%. Individually, first pass success was 60.0% for VT, 68.8% for GL, and 64.5% for DL. A chi-square test revealed no statistically significant difference amongst the three devices for first pass success rates (P=.583). Average time to successful intubation was 42.2 seconds for VT, 38.0 seconds for GL, and 33.7 for seconds for DL. The average number of intubation attempts for each device were as follows: 1.48 for VT, 1.40 for GL, and 1.42 for DL.

Conclusion

The was no statistically significant difference in first pass or overall successful ETI rates between DL and video laryngoscopy (VL) with either the GL or VT (adult).

HodnickR, ZitekT, GalsterK, JohnsonS, BledsoeB, EbbsD. A Comparison of Paramedic First Pass Endotracheal Intubation Success Rate of the VividTrac VT-A 100, GlideScope Ranger, and Direct Laryngoscopy Under Simulated Prehospital Cervical Spinal Immobilization Conditions in a Cadaveric Model. Prehosp Disaster Med. 2017;32(6):621–624.

Keywords

airway managementEmergency Medical Servicesintubationparamedicsprehospitalspinal immobilizationvideo laryngoscope
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 32 , Issue 6 , December 2017 , pp. 621 - 624
Copyright
© World Association for Disaster and Emergency Medicine 2017 

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Footnotes

Conflicts of interest/funding: Funding for the study was provided by the Valente Fund, University of New Mexico (Albuquerque, New Mexico USA), Department of Emergency Medicine; author RH was associated with the University at the time of the study but is no longer with them. The authors declare no conflicts of interest.

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