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Efficacy of the Disposcope endoscope, a new video laryngoscope, for endotracheal intubation in patients with cervical spine immobilisation by semirigid neck collar: comparison with the Macintosh laryngoscope using a simulation study on a manikin
  1. Sang O Park1,
  2. Dong Hyuk Shin2,
  3. Kyeong Ryong Lee1,
  4. Dae Young Hong1,
  5. Eun Jung Kim3,
  6. Kwang Je Baek1
  1. 1Department of Emergency Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
  2. 2Department of Emergency Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
  3. 3College of Nursing, Eulji University, Seongnam-Si, Gyeonggi-Do, Korea
  1. Correspondence to Professor Kwang Je Baek, Department of Emergency Medicine, Konkuk University Medical Center, Konkuk, University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, Seoul 143-729, Korea; smc125{at}medimail.co.kr

Abstract

Objective To evaluate whether endotracheal intubation in patients with cervical spine immobilisation by a semirigid neck collar is easier using the Disposcope endoscope (DE), a new video laryngoscope, than with the Macintosh laryngoscope (ML).

Methods Sixty-eight medical interns who participated in a training programme for endotracheal intubation using the DE and ML were recruited to the randomised crossover trial 1 week after completing the training programme. In the trial, they used both the DE and the ML to perform intubation on a manikin wearing a semirigid neck collar. The time required to view the vocal cords and to complete intubation, successful endotracheal intubation, modified Cormack–Lehane classification (CL grade) and dental injury were recorded and analysed.

Results The mean (SD) time to view the vocal cords was significantly shorter with the DE than with the ML (10.0 (7.0) vs 20.8 (18.9) s; p<0.0001). There were higher rates of CL grades 1 and 2a (69.1% and 22.1%) using the DE than with the ML (10.3% and 14.7%). All 68 participants had a higher rate of successful endotracheal intubation using the DE than using the ML (68 (100%) vs 47 (69.1%); p<0.0001). It took less time to complete endotracheal intubation with the DE than with the ML (p<0.0001).

Conclusions In patients with cervical spine immobilisation by a semirigid neck collar, the DE may be a more effective device for endotracheal intubation than the ML.

  • Trauma
  • airway
  • RSI
  • spinal
  • respiratory
  • emergency care systems
  • emergency departments
  • resuscitation
  • training
  • chest
  • cardiac care
  • care systems
  • pre-hospital

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Footnotes

  • Funding This work was supported by Konkuk University in 2011.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the Institutional Review Board for Human Research at Konkuk University Medical Center (No: KUH005126).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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