A study of comparing the first-attempt success of endotracheal intubation and complication rates between glidescope video laryngoscopy and direct laryngoscopy in the emergency department

Park, Jun Wan; Kim, Sin Young; Kim, Jong Won; Hong, Dae Young; Lee, Kyeong Ryong; Baek, Kwang Je; Park, Sang O

J Korean Soc Emerg Med > Volume 32(1); 2021 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2021;32(1): 11-18.

응급의료센터 내 비디오 후두경과 직접 후두경의 첫 번째 시도에서의 기관내삽관 성공률과 부작용 발생률 비교 연구

박준완

건국대학교 의학전문대학원 응급의학교실

A study of comparing the first-attempt success of endotracheal intubation and complication rates between glidescope video laryngoscopy and direct laryngoscopy in the emergency department

Department of Emergency Medicine, Konkuk University School of Medicine, Seoul, Korea

Correspondence

Sang O Park ,Tel: 02-2030-5551, Fax: 02-2030-5780, Email: empso@kuh.ac.kr,

Received: June 24, 2020; Revised: August 20, 2020 Accepted: August 24, 2020. Published online: February 26, 2021.

ABSTRACT

Objective:
The study compared the first-attempt success and complication rates of endotracheal intubation (ETI) using video laryngoscopy (VL; GlideScope) with those of direct laryngoscopy (DL) in the emergency department (ED).
Method:
This was a retrospectively clinical study of adult patients who underwent intubation using from 2010 to 2014 in the ED. All data were collected from the electronic medical records. The primary outcome was the first-attempt intubation success of ETI. The secondary outcomes were occurrences of desaturation, hypotension, oesophageal intubation, dental injuries, and cardiac arrest. The between-device differences in outcome risks were examined.
Results:
A total of 431 emergency ETIs were included. The first-attempt intubation success rate was higher in the VL than DL (93.8% vs. 74.8%, P<0.001). The non-expert emergency physicians (first and second-year residents) showed a higher first-attempt intubation success rate in VL than DL, but there was no difference in the first-attempt intubation success rate between the two devices between experts (third and fourth-year residents). The use of VL was associated with a lower rate of desaturation (0.0% vs. 5.0%) and tooth injuries (0.0% vs. 2.7%) compared to the DL.
Conclusion:
The use of VL was associated with a higher first-attempt success rate compared to DL, particularly in inexperienced intubators. For complications related to ETI, VL showed a lower rate of desaturation and dental injuries in the ED than the DL.

Key words: Video laryngoscopy; Direct laryngoscopy; Airway management; Emergency department