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Background: Trauma patients who entrapped in the accident vehicle are predispose to have cervical spine injuries and they needed to be intubated with face-to-face intubation technique using Macintosh laryngoscope. Nowadays, video laryngoscope has been introduced to improve the intubation technique.
Objective: To compare the effectiveness of video laryngoscope and Macintosh laryngoscope for face-to-face intubation in sitting manikin model with limitation of neck motion.
Methods: The study was performed in a randomized experimental study. Subjects were divided into 2 groups both did face-to-face intubation using video laryngoscope and Macintosh laryngoscope in a sitting manikin model with limitation of neck motion. The success rate of intubation, time to finish intubation, and vocal cord visualization were analyzed.
Results: Of 41 subjects including 2nd and 3rd year paramedic students, 21 subjects went to video laryngoscope group, and 20 subjects went to Macintosh laryngoscopes group. The Macintosh laryngoscope intubation technique showed significantly better success rate compared to video laryngoscope (100% and 25%, P < .001). In addition, intubation time of Macintosh laryngoscope was significantly less than video laryngoscope (mean [SD], 27 [24.7] and 75 [66.3] seconds, P < .001). However, vocal cord visualization from both laryngoscope techniques showed no statistically significant (P = .08).
Conclusions: Intubation training of Macintosh laryngoscope for in sitting model with neck motion limitation showed better success rate and less time than video laryngoscope, with the same vocal cord visualization.
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2. Li F, Liu NS, Li HG, Zhang B, Tian SW, Tan MG, et al. A review of neck injury and protection in vehicle accidents. Transportation Safety and Environment. 2019;1(2):89-105. doi:10.1093/tse/tdz012
3. Chiu WC, Haan JM, Cushing BM, Kramer ME, Scalea TM. Ligamentous injuries of the cervical spine in unreliable blunt trauma patients: incidence, evaluation, and outcome. J Trauma. 2001;50(3):457-463. doi:10.1097/00005373-200103000-00009
4. Barati K, Arazpour M, Vameghi R, Abdoli A, Farmani F. The effect of soft and rigid cervical collars on head and neck immobilization in healthy subjects. Asian Spine J. 2017;11(3): 390-395. doi:10.4184/asj.2017.11.3.390
5. Ghorbani F, Kamyab M, Azadinia F, Hajiaghaei B. Open-design collar vs conventional Philadelphia collar regarding user satisfaction and cervical range of motion in asymptomatic adults. Am J Phys Med Rehabil. 2016;95(4):291-299. doi:10.1097/PHM.0000000000000374
6. Phillips S, Celenza A. Comparison of the Pentax AWS video laryngoscope with the Macintosh laryngoscope in simulated difficult airway intubations by emergency physicians. Am J Emerg Med. 2011;29(8):863-867. doi:10.1016/j.ajem.2010.03.024
7. Su YC, Chen CC, Lee YK, Lee JY, Lin KJ. Comparison of video laryngoscopes with direct laryngoscopy for tracheal intubation: a meta-analysis of randomised trials. Eur J Anaesthesiol. 2011;28(11):788-795. doi:10.1097/EJA.0b013e32834a34f3
8. Akbar SH, Ooi JS. Comparison between C-MAC video-laryngoscope and Macintosh direct laryngoscope during cervical spine immobilization. Middle East J Anaesthesiol. 2015;23(1):43-50.
9. Aziz M, Dillman D, Kirsch JR, Brambrink A. Video laryngoscopy with the Macintosh video laryngoscope in simulated prehospital scenarios by paramedic students. Prehosp Emerg Care. 2009;13(2):251-255. doi:10.1080/10903120802706070
10. Nandakumar KP, Bhalla AP, Pandey RK, Baidya DK, Subramaniam R, Kashyap L. Comparison of Macintosh, McCoy, and Glidescope video laryngoscope for intubation in morbidly obese patients: randomized controlled trial. Saudi J Anaesth. 2018;12(3):433-439. doi:10.4103/sja.SJA_754_17
11. Raimann FJ, Tepperis DM, Meininger D, et al. Comparing four video laryngoscopes and one optical laryngoscope with a standard Macintosh blade in a simulated trapped car accident victim. Emerg Med Int. 2019;2019:9690839. doi:10.1155/2019/9690839
12. Aleksandrowicz D, Gaszynski T. Airway management with cervical spine immobilization: a comparison between the Macintosh laryngoscope, Truview Evo2, and Totaltrack VLM used by novices a manikin study. Biomed Res Int. 2016;2016:1297527. doi:10.1155/2016/1297527
13. Park SO, Shin DH, Lee KR, Hong DY, Kim EJ, Baek KJ. Efficacy of the Disposcope endoscope, a new video laryngoscope, for endotracheal intubation in patients with cervical spine immobilization by semirigid neck collar: comparison with the Macintosh laryngoscope using a simulation study on a manikin. Emerg Med J. 2013;30(4):270-274. doi:10.1136/emermed-2011-200899
14. Kim JK, Kim JA, Kim CS, Ahn HJ, Yang MK, Choi SJ. Comparison of tracheal intubation with the Airway Scope or Clarus Video System in patients with cervical collars. Anaesthesia. 2011;66(8):694-698. doi:10.1111/j.1365-2044.2011.06762.x
15. Maruyama K, Yamada T, Kawakami R, Hara K. Randomized cross-over comparison of cervical-spine motion with the AirWay Scope or Macintosh laryngoscope with in-line stabilization: a video-fluoroscopic study. Br J Anaesth. 2008;101(4):563-567. doi:10.1093/bja/aen207
16. Yuksen C, Prachanukool T, Chinsupaluk W, Trainarongsakul T. Video laryngoscope versus Macintosh laryngoscope in stimulated patients with limitation of neck movements. Rama Med J. 2014;37(2):71-80.
17. Krage R, van Rijn C, van Groeningen D, Loer SA, Schwarte LA, Schober P. Cormack-Lehane classification revisited. Br J Anaesth. 2010;105(2):220-227. doi:10.1093/bja/aeq136