Direct vs. Video-laryngoscopy for intubation by paramedics of simulated COVID-19 patients under cardiopulmonary resuscitation: A randomized crossover trial

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  • Leszek Gadek
  • Lukasz Szarpak
  • Konge, Lars
  • Marek Dabrowski
  • Dominika Telecka-Gadek
  • Maciej Maslanka
  • Wiktoria Laura Drela
  • Marta Jachowicz
  • Lukasz Iskrzycki
  • Szymon Bialka
  • Frank William Peacock
  • Jacek Smereka

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 languageEnglish
Article number5740
JournalJournal of Clinical Medicine
Volume10
Issue number24
Number of pages10
ISSN2077-0383
DOIs
Publication statusPublished - 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.

    Research areas

  • COVID-19, McGrath MAC, Medical simulation, Personal protective equipment, SARS-CoV-2, Sdirect laryngoscopy, Video-laryngoscopes

ID: 301615322