Efficacy of RAMA Mobile Video Laryngoscope (RAMA-mVL) for Tracheal Intubation in Manikin: A Randomized Study

Panvilai Tangkulpanich; Natsinee Athinartrattanapong; Porawin Ussawapitanon; Phanorn Chalermdamrichai; Jarupol Tuangsirisup

doi:10.33165/rmj.2021.44.4.249901

Authors

Panvilai Tangkulpanich Department of Emergency Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Natsinee Athinartrattanapong Department of Emergency Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Porawin Ussawapitanon Emergency Department, Rayong Hospital, Rayong, Thailand
Phanorn Chalermdamrichai Department of Emergency Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Jarupol Tuangsirisup Emergency Department, Kalasin Hospital, Kalasin, Thailand

DOI:

https://doi.org/10.33165/rmj.2021.44.4.249901

Keywords:

Video laryngoscope, First-pass succession rate, Time to intubation

Abstract

Background: Video laryngoscope (VL) is a tool that has increased the intubation success rate, but it is expensive and difficult to carry outside the hospital. Ramathibodi mobile Video laryngoscope (RAMA-mVL) thus was invented for having effectiveness equivalent to the current device and lower price.

Objective: To determine the effectiveness of intubation by comparing between RAMA-mVL and McGrath^®.

Methods: This study conducted a randomized, single-blinded study in manikin comparing RAMA-mVL and McGrath^®. Medical personnel with intubation experiences were included and will be trained in 2 devices before performing the procedures. Intubation success rate, time to intubation, satisfaction, and the cost between both VLs were compared.

Results: A total of 208 persons were enrolled in the research, 104 in each group. The first pass succession rate for intubation by using both VLs is 100%. Time to intubation using RAMA-mVL was significantly less than that of McGrath^® (mean [SD], 9.12 [4.28] and 11.19 [5.04] seconds, respectively; P = .002). The 5-point Likert scale in satisfaction rate on the easy to build in RAMA-mVL and McGrath^® were mean (SD) of 4.88 (0.32) and 4.23 (0.96) points respectively (95% CI, 0.46 - 0.85; P < .001). Additionally, the cost of RAMA-mVL was cheaper than McGrath^®.

Conclusions: The first pass intubation success rate in a manikin of RAMA-mVL is equivalent to McGrath^®. The cost of RAMA-mVL is cheaper.

References

Nouruzi-Sedeh P, Schumann M, Groeben H. Laryngoscopy via Macintosh blade versus GlideScope: success rate and time for endotracheal intubation in untrained medical personnel. Anesthesiology. 2009;110(1):32-37. doi:10.1097/ALN.0b013e318190b6a7

Timmermann A, Russo SG, Crozier TA, et al. Novices ventilate and intubate quicker and safer via intubating laryngeal mask than by conventional bag-mask ventilation and laryngoscopy. Anesthesiology. 2007;107(4):570-576. doi:10.1097/01.anes.0000281940.92807.23

Hohlrieder M, Brimacombe J, von Goedecke A, Keller C. Guided insertion of the ProSeal laryngeal mask airway is superior to conventional tracheal intubation by first-month anesthesia residents after brief manikin-only training. Anesth Analg. 2006;103(2):458-462. doi:10.1213/01.ane.0000223679.14471.6c

Kim KN, Jeong MA, Oh YN, Kim SY, Kim JY. Efficacy of Pentax airway scope versus Macintosh laryngoscope when used by novice personnel: a prospective randomized controlled study. J Int Med Res. 2018;46(1):258-271. doi:10.1177/0300060517726229

Kleine-Brueggeney M, Greif R, Schoettker P, Savoldelli GL, Nabecker S, Theiler LG. Evaluation of six videolaryngoscopes in 720 patients with a simulated difficult airway: a multicentre randomized controlled trial. Br J Anaesth. 2016;116(5):670-679. doi:10.1093/bja/aew058

Mosier J, Chiu S, Patanwala AE, Sakles JC. A comparison of the GlideScope video laryngoscope to the C-MAC video laryngoscope for intubation in the emergency department. Ann Emerg Med. 2013;61(4):414-420.e1. doi:10.1016/j.annemergmed.2012.11.001

Soar J, Nolan JP, Böttiger BW, et al. European Resuscitation Council Guidelines for Resuscitation 2015: Section 3. Adult advanced life support. Resuscitation. 2015;95:100-147. doi:10.1016/j.resuscitation.2015.07.016

Boedeker BH, Nicholsal TA 4th, Carpenter J, et al. A comparison of direct versus indirect laryngoscopic visualization during endotracheal intubation of lightly embalmed cadavers utilizing the GlideScope®, Storz Medi Pack Mobile Imaging System™ and the New Storz CMAC™ videolaryngoscope. J Spec Oper Med. 2011;11(2):21-29.

Szarpak L, Karczewska K, Evrin T, Kurowski A, Czyzewski L. Comparison of intubation through the McGrath MAC, GlideScope, AirTraq, and Miller Laryngoscope by paramedics during child CPR: a randomized crossover manikin trial. Am J Emerg Med. 2015;33(7):946-950. doi:10.1016/j.ajem.2015.04.017

Eberlein CM, Luther IS, Carpenter TA, Ramirez LD. First-Pass success intubations using video laryngoscopy versus direct laryngoscopy: a retrospective prehospital ambulance service study. Air Med J. 2019;38(5):356-358. doi:10.1016/j.amj.2019.06.004