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This month’s update comes from authors from the Department of Emergency Medicine, Stanford Medicine. We used a multimodal search strategy that drew on free open-access medical education resources and literature searches. We reviewed all papers published between 15 March 2022 and 15 April 2022. We identified the five most interesting and relevant papers (decided by consensus) and highlight the main findings, key limitations and clinical bottom line for each paper. The papers are placed into one of three categories, allowing you to assess those which are most relevant to your practice:
Worth a peek—interesting, but not yet ready for prime time.
Head turner—new concepts.
Game changer—this paper could/should change practice.
Video laryngoscopy versus direct laryngoscopy for adults undergoing tracheal intubation. Cochrane Database of Systematic Reviews by Hansel et al
Topic: medical devices
Rating: head turner
In this Cochrane update, the researchers compared the risks, benefits and failure rates of the newer video laryngoscopy (VL) methods with the traditional direct laryngoscopy (DL).
This review article included 222 studies (219 randomised controlled trials (RCTs) and 3 quasi-RCTs) with 26 149 participants. The authors searched the sources on 27 February 2021 and reported data on three main comparisons. In the first comparison, Macintosh-style VL versus DL, VL had higher first-pass intubation and reduced failed intubation and hypoxaemia. The authors were moderately confident that it improved glottic view in Cormack Lehane grade 3 and 4 airways. In the second comparison, hyperangulated VL versus DL, the authors noted higher first-pass intubation, improved glottic view and reduced failed or oesophageal intubation in known or predicted difficult airways. There was no clear evidence of the effects on hypoxaemia. In the third comparison, channelled VL versus DL, the authors found higher first-pass intubation and improved glottic view. In addition, channelled VL reduced failed intubation and hypoxaemia; no effect on oesophageal intubation was noted. The authors could not assess the impact on dental …
Twitter @MonicaRSaxena, @roseliketheflwr, @hirstposition
Contributors All authors have contributed in line with ICMJE guidelines.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.