Direct Versus Video Laryngoscopy in Emergency Intubation: A Randomized Control Trial Study

Abstract

Objective: To compare the intubation success rate of the first attempt between Video Laryngoscopy (VDL) and Direct Laryngoscopy (DL) in the emergency department (ED). Methods: This is a study of a randomized control trial includes the patients with acute respiratory failure and the emergency physician who intended to perform intubation in the ED from July 2015 to June 2016. We were selected the patients randomly by the sequentially numbered opaque sealed envelopes technique and were assigned to undergo the first attempt of either VDL (n=78) or DL (n=80). We collected the data information regarding the demographic characteristics, predictors of difficult intubation, rapid sequence intubation, attempt, Cormack–Lehane view, and immediate complications. Results: The success of VDL in the first attempt was 73.1%, which were tended to be better than DL (58.8%) (p=0.060). Glottis view (Cormack–Lehane view 1–2) of VDL was significantly better (88.5%) than of DL (72.5%) (p=0.010). The immediate complications were not different. Conclusions: VDL showed a trend of better success than DL. VDL can increase the first-attempt intubation success and provide a better glottis view in emergency intubation. Trial registration: The trial was registered in the Thai Clinical Trial Registry, identifier TCTR 20200503003. Registered 16 June 2020, ‘Retrospectively registered’, http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=6186

Keywords

• video laryngoscopy
• macintosh direct laryngoscope
• emergency department