Direct vs. Video-laryngoscopy for intubation by paramedics of simulated COVID-19 patients under cardiopulmonary resuscitation: A randomized crossover trial
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A safe way of securing the airway with an endotracheal tube is one of the priorities of an advanced cardiovascular life support algorithm for suspected or confirmed COVID-19 patients. The aim of this study was to compare intubation success rates (ISR) and intubation time (IT) of different laryngoscopes for simulated COVID-19 patients under cardiopulmonary resuscitation. The study was designed as a prospective, randomized, crossover trial. Fifty four active paramedics performed endotracheal intubation with a Macintosh direct laryngoscope (MAC) and McGrath videolaryngoscope (McGrath) with and without personal protective equipment (PPE). Without PPE, ISRs were 87% and 98% for MAC and McGrath, respectively (p = 0.32). ITs were 22.5 s (IQR: 19–26) and 19.5 s (IQR: 17–21) for MAC and McGrath, respectively (p = 0.005). With PPE, first-pass ISR were 30% and 89% with MAC and McGrath, respectively (p < 0.001). The overall success rates were 83% vs. 100% (p = 0.002). Median ITs were 34.0 s (IQR: 29.5–38.5) and 24.8 s (IQR: 21–29) for MAC and McGrath, respectively (p < 0.001). In conclusion, the McGrath videolaryngoscope appears to possess significant advantages over the Macintosh direct laryngoscope when used by paramedics in suspected or confirmed COVID-19 intubation scenarios.
Original language | English |
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Article number | 5740 |
Journal | Journal of Clinical Medicine |
Volume | 10 |
Issue number | 24 |
Number of pages | 10 |
ISSN | 2077-0383 |
DOIs | |
Publication status | Published - 2021 |
Bibliographical note
Funding Information:
Acknowledgments: The study was supported by the ERC Research Net and by the Polish Society of Disaster Medicine.
Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
- COVID-19, McGrath MAC, Medical simulation, Personal protective equipment, SARS-CoV-2, Sdirect laryngoscopy, Video-laryngoscopes
Research areas
ID: 301615322