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Direct laryngoscopy using video-laryngoscope for endo-tracheal intubation in the Emergency Department: An educational and patient safety initiative
Author(s) -
Alhady Bin Alfian Yusof,
Zeinab Mostafa,
Saleem Farook,
Kostantinos Morley,
Mudassar Rasool,
Dharmesh Shukla
Publication year - 2016
Publication title -
journal of emergency medicine, trauma and acute care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.27
H-Index - 5
eISSN - 1999-7094
pISSN - 1999-7086
DOI - 10.5339/jemtac.2016.icepq.18
Subject(s) - laryngoscopy , video laryngoscope , intubation , endotracheal intubation , airway management , medicine , session (web analytics) , airway , medical emergency , endotracheal tube , resuscitation , emergency medical services , first aid , anesthesia , computer science , world wide web
Background: Conventional endotracheal intubation (ETI) is challenging and requires high level of individual skills and experience. At the same time we are also committed to provide ETI training for Emergency Medicine Residents (EMR). Video laryngoscope (VDL) like the C-MAC (by Karl Storz) is designed to have a similar blade to the normal Macintosh blades (size 3 and 4). It has a bright light source and blade thickness that allow Direct Laryngoscopy (DL) and hence ETI under direct vision. We organised several sessions of ETI training using an intubating manikin. We found that the view from the C-MAC screen captured by the C-MAC video camera is the same view described by the operator doing the DL. There were enough consistencies reported during several training sessions that we decided to use the C-MAC for DL in real cases of ETI in the resuscitation room. We have done several ‘live’ cases and all intubations successfully as DL, with the added benefit of ‘video supervision’ and ‘video confirmation’ of the tube positioning. We also used the video recording and playback functions to give feedback to the EMR at the end of the procedure. Methods (Case Report): In this educational poster, we describe a step-by-step laryngoscopic and ETI view seen on the C-MAC screen during one of our airway training session with the manikin. We also include several views of possible poor technique in laryngoscopy that may result in a failed intubation attempt. Results: We discuss the potential safety and training benefits in conventional ETI using C-MAC VDL. Conclusion: We conclude that promoting the use of this technique in ED, especially for ETI undertaken by a trainee improves patient safety and supervision.

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