Korean J Crit Care Med.  2013 Nov;28(4):241-246. 10.4266/kjccm.2013.28.4.241.

Comparison of Intubation Success Rate and Times Required for Intubation by Glottic Exposure Methods with Glidescope(R)

• Jang HS
• Park JB
• Oh JH
• Kim CS
• Choi HJ
• Kang BS
• Lim TH
• Kang HG

• KMID: 1977499
• DOI: http://doi.org/10.4266/kjccm.2013.28.4.241

Abstract

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.

Keyword

intubation; laryngoscope; videolaryngoscope

MeSH Terms

Epiglottis
Glottis
Humans
Intubation*
Intubation, Intratracheal
Laryngoscopes
Manikins
Methods*
Prospective Studies
Students, Medical
Vocal Cords