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The C-MAC videolaryngoscope for prehospital emergency intubation: a prospective, multicentre, observational study
  1. Erol Cavus1,
  2. Andreas Callies2,
  3. Volker Doerges1,
  4. Gilbert Heller1,
  5. Sabine Merz3,
  6. Peter Rösch1,
  7. Markus Steinfath1,
  8. Matthias Helm4
  1. 1Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
  2. 2Department of Anaesthesiology, Intensive Care Medicine and Emergency Medicine, Hospital Links der Weser, Bremen, Germany
  3. 3Department of Anaesthesiology and Intensive Care Medicine, Schwarzwald-Baar Hospital, Villingen-Schwenningen, Germany
  4. 4Department of Anaesthesiology and Intensive Care Medicine, Federal Armed Forces Medical Centre Ulm, Germany
  1. Correspondence to Dr Erol Cavus, University Hospital Schleswig-Holstein, Campus Kiel, Department of Anaesthesiology and Intensive Care Medicine, Schwanenweg 21, D-24105 Kiel, Germany; cavus{at}


Background In this preliminary prospective observational study at four physician-led air rescue centres, the efficacy of the C-MAC (Karl Storz, Tuttlingen, Germany), a new portable videolaryngoscope, was evaluated during prehospital emergency endotracheal intubations.

Methods 80 consecutive patients requiring prehospital emergency intubation, treated by a physician introduced in the use of the C-MAC were enrolled in this study.

Results Indication for prehospital intubation was trauma in 45 cases (including maxillo-facial trauma in 10 cases), cardiopulmonary resuscitation in 14 cases, and unconsciousness of neurological aetiology and cardiogenic dyspnoea in 21 cases. Forty-nine patients were intubated with a C-MAC blade size 3, and 31 with a C-MAC blade size 4. Median time to successful intubation was 20 (min−max: 5−300) seconds; 63 patients were intubated on the first attempt, 13 on the second and four after more than two attempts. A Cormack-Lehane class 1 view of the glottis was seen in 46 patients, class 2a view in 21, class 2b in eight, class 3 in three and class 4 in two. Six patients could not be intubated with the videolaryngoscopic view, but were successfully intubated at the same attempt using the C-MAC with the direct laryngoscopic view.

Conclusion The C-MAC videolaryngoscope was suitable for prehospital emergency endotracheal intubations with complicated airway conditions, such as maxillo-facial trauma. The option to perform direct laryngoscopy and videolaryngoscopy with the same device appears to be exceptionally important in the prehospital setting.

  • Air ambulances
  • emergency medical service
  • emergency treatment
  • laryngoscopy
  • laryngoscopes
  • acute medicine-other
  • airway
  • management
  • quality assurance
  • prehospital care
  • doctors in PHC
  • trauma
  • major trauma management

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  • See Commentary, p 643

  • Linked articles 105221.

  • Presented as an abstract at the 1st German Interdisciplinary Emergency Medicine Congress (DINK) February 2010.

  • Competing interests The University Hospital Schleswig-Holstein Campus Kiel, Department of Anaesthesiology and Intensive Care Medicine, or any of its employees, receive no compensation for this work. However, Volker Doerges is a member of the Karl Storz advisory board, and receives grant support from Karl Storz, Tuttlingen, Germany, for studies related to airway management.

  • Ethics approval This study was conducted with the approval of the Institutional review board of the University of Kiel.

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

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