An Easy Way To Simplify Intubation During Arrest

Written by Clay Smith

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Video laryngoscopy (VL) improved first-pass success over direct laryngoscopy (DL) when intubating during cardiac arrest, 78% vs 70%, respectively.

Why does this matter?
We recently covered several articles that showed how difficult intubation is during cardiac arrest, AIRWAYS-2, PART, and a look at how many intubations it takes to become facile during arrest. Here is a simple way to increase success when intubating during arrest - VL.

Video beat DL in arrest
This was a prospective multicenter study of 3,360 intubations in cardiac arrest patients. First-pass success was higher when VL was used compared to DL, 78% vs. 70%. The subgroup with C-MAC use was even better - 80% vs. 70% with DL. VL also dramatically improved glottic visualization and reduced esophageal intubation. They used various devices: C-MAC, McGrath, Airway Scope, and GlideScope. Most intubations used DL, 82% vs 18% VL. I see no reason to not start with VL when intubating cardiac arrest patients. It’s hard enough. Give yourself and your patient every advantage.

Source
Comparison of video laryngoscopy versus direct laryngoscopy for intubation in emergency department patients with cardiac arrest: A multicentre study. Resuscitation. 2018 Oct 29. pii: S0300-9572(18)30984-5. doi: 10.1016/j.resuscitation.2018.10.005. [Epub ahead of print]

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