J Korean Soc Emerg Med.  2022 Jun;33(3):225-232.

A clinical study of comparing the first-attempt success of endotracheal intubation between video laryngoscopy and direct laryngoscopy for trauma patient with suspected cervical injury

• Won JC
• Lee S
• Kim SY
• Kim JW
• Hong DY
• Lee KR
• Baek KJ
• Park SO

Abstract

Objective
This study aimed to evaluate the effectiveness of video laryngoscopy (VL; Glidescope) compared to direct laryngoscopy (DL) when performing endotracheal intubation (ETI) in trauma patients with cervical spine immobilization.
Methods
This was a retrospective clinical study. A total of 98 trauma patients with cervical spine immobilization were included. These patients underwent intubation using VL and DL from 2009 to 2014 in the emergency department. All data were collected through electronic medical records. The primary outcome was the first-attempt intubation success rate of ETI. Secondary outcomes were complications of ETI, including esophageal intubation and tooth injuries. We compared the outcomes of the two devices.
Results
VL showed higher first-attempt ETI success rates compared to DL (94.0% vs. 74.5%, P=0.011). There were no statistically significant differences in the ETI complication rates between VL and DL such as esophageal intubation (2.0% vs. 4.3%, P=0.610) and tooth injuries (6.0% vs. 10.6%, P=0.478). The multivariate analysis showed that VL was an independent factor for predicting higher first-attempt intubation success with an odds ratio of 4.538 (95% confidence interval, 1.084-18.988; P=0.038)
Conclusion
For patients with cervical spine immobilization, VL could provide a higher first-attempt ETI success rate compared to DL in a real clinical setting.

Keyword

Intubation; Video laryngoscopy; Direct laryngoscopy; Airway management; Emergency department