Department of Anaesthesiology, University Medical Center of the Johannes Gutenberg-University-Mainz, Langenbeckstrasse 1, Mainz, Germany.
Scand J Trauma Resusc Emerg Med. 2011 Jan 17;19(1):4. doi: 10.1186/1757-7241-19-4.
Out-of-hospital endotracheal intubation performed by paramedics using the Macintosh blade for direct laryngoscopy is associated with a high incidence of complications. The novel technique of video laryngoscopy has been shown to improve glottic view and intubation success in the operating room. The aim of this study was to compare glottic view, time of intubation and success rate of the McGrath® Series 5 and GlideScope® Ranger video laryngoscopes with the Macintosh laryngoscope by paramedics.
Thirty paramedics performed six intubations in a randomised order with all three laryngoscopes in an airway simulator with a normal airway. Subsequently, every participant performed one intubation attempt with each device in the same manikin with simulated cervical spine rigidity using a cervical collar. Glottic view, time until visualisation of the glottis and time until first ventilation were evaluated.
Time until first ventilation was equivalent after three intubations in the first scenario. In the scenario with decreased cervical motion, the time until first ventilation was longer using the McGrath® compared to the GlideScope® and AMacintosh (p < 0.01). The success rate for endotracheal intubation was similar for all three devices. Glottic view was only improved using the McGrath® device (p < 0.001) compared to using the Macintosh blade.
The learning curve for video laryngoscopy in paramedics was steep in this study. However, these data do not support prehospital use of the McGrath® and GlideScope® devices by paramedics.
急救人员使用 Macintosh 叶片进行的院外气管插管与直接喉镜检查相关联，并发症发生率很高。视频喉镜的新技术已被证明可改善手术室中的声门视图和插管成功率。本研究的目的是比较 Macintosh 喉镜、McGrath®Series 5 和 GlideScope® Ranger 视频喉镜在急救人员中的声门视图、插管时间和成功率。
30 名急救人员在气道模拟器中以随机顺序使用所有三种喉镜进行六次插管，气道正常。随后，每个参与者都使用颈托在同一个模拟人身上模拟颈椎僵硬进行了一次尝试。评估声门视图、可视化声门所需的时间和首次通气所需的时间。
在第一个场景中，三次插管后首次通气的时间相等。在颈椎运动减少的情况下，使用 McGrath®与 GlideScope®和 AMacintosh 相比，首次通气的时间更长（p <0.01）。三种设备的气管插管成功率相似。与 Macintosh 叶片相比，仅使用 McGrath®设备可改善声门视图（p <0.001）。
在这项研究中，急救人员的视频喉镜学习曲线很陡峭。然而，这些数据不支持在院前使用 McGrath®和 GlideScope®设备。
