Prior studies have clearly proven a video laryngoscopes (VL) generally provide a better view of the chords. But does this translate into
improved first pass success rates of intubation?
This study tried to determine which is ultimately better;
a C-MAC or old fashion direct laryngoscopy (DL)? This is probably
a decent research question.
150 ED patients undergoing RSI in a single ED in
Zurich were randomised to either C-MAC vs. DL.
For "ethical reasons" they excluded patients that they
thought would be difficult to intubate. The primary outcome measure was
first pass success rate. It was powered to find a 14% difference between the
groups.
Unfortunately, all intubations were performed by one of
three “very experienced” anaesthetic consultants.
Can you guess the first pass success rate for “very
experienced” anaesthetists for simple intubations?
Yes, you guessed it… 100% in both groups. (Well, just
about.)
This study was never going to find a difference and I
wonder why they went to so much effort in the first place. Seems like it was
always going to be a waste of time.
We already know that video laryngoscopes are taking over. But
what do you do when the scope fails, unavailable, or needs rescue?
Learn both.
Covering
Sulser S, Ubmann D, Schlaepfer, et al. C-MAC
videolaryngoscope compared with direct laryngoscopy for rapid sequence intubation
in an emergency department. Eur J Anaesthesiol 2016;33:1-6. [link to article]
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