By Bill Carey
EMS1
BAYONNE, N.J. — Researchers at Vanderbilt University Medical Center investigated the effectiveness of two laryngoscope types in tracheal intubation of critically ill patients. The findings revealed that employing a video laryngoscope significantly improved the success rate of intubation on the initial attempt when compared to the traditional approach of using a direct laryngoscope.
The DEVICE (DirEct Versus VIdeo LaryngosCopE) trial, published in the “New England Journal of Medicine,” compared the two devices used to intubate patients in the emergency department and the intensive care unit: a direct laryngoscope and a video laryngoscope, the VUMC Reporter stated.
The study encompassed a sample of 1,417 patients from 17 emergency departments and ICUs in 11 hospitals across the nation. Its primary objective was to determine which device was better for achieving successful insertion of the breathing tube on the initial attempt.
“In our randomized trial successful intubation on the first attempt occurred in 71% of patients in the direct laryngoscope group and 85% of patients in the video laryngoscope group, a 14% absolute increase,” Matthew Prekker, MD, MPH, assistant professor of emergency medicine and internal medicine at Hennepin County Medical Center, and first author of the study said.
The study also looked at complications following unsuccessful intubation, such as cardiac arrest, and determined that using a video laryngoscope can prevent such complications; but a larger research trial would be needed.
The study showed using the video laryngoscope would be especially helpful for the less experienced clinician.