Publication

Determination of the optimal stylet strategy for the c-mac®videolaryngoscope

McElwain, J.
; 
Malik, M. A.
; 
Harte, B. H.
; 
Flynn, N. H.
; 
Laffey, J. G.
Identifiers
http://hdl.handle.net/10379/12773
https://doi.org/10.13025/28898
Repository DOI
10.1111/j.1365-2044.2010.06245.x
Publication Date
2010-03-01
Keywords
cervical-spine immobilization, closed claims analysis, tracheal intubation, macintosh laryngoscope, endotracheal intubation, novice personnel, truview evo2(r), clinical-trial, airtraq(r), mannequin
Type
Article
Downloads
Show all metadata
Citation
McElwain, J. Malik, M. A.; Harte, B. H.; Flynn, N. H.; Laffey, J. G. (2010). Determination of the optimal stylet strategy for the c-mac®videolaryngoscope. Anaesthesia 65 (4), 369-378
Abstract
The C-MAC (R) videolaryngoscope is a novel intubation device that incorporates a camera system at the end of its blade, thereby facilitating obtaining a view of the glottis without alignment of the oral, pharyngeal and tracheal axes. It retains the traditional Macintosh blade shape and can be used as a direct or indirect laryngoscope. We wished to determine the optimal stylet strategy for use with the C-MAC. Ten anaesthetists were allowed up to three attempts to intubate the trachea in one easy and three progressively more difficult laryngoscopy scenarios in a SimMan (R) manikin with four tracheal tube stylet strategies: no stylet; stylet; directional stylet (Parker Flex-It (TM)); and hockey-stick stylet. The use of a stylet conferred no advantage in the easy laryngoscopy scenario. In the difficult scenarios, the directional and hockey-stick stylets performed best. In the most difficult scenario, the median (IQR [range])duration of the successful intubation attempt was lowest with the hockey-stick stylet; 18 s (15-22 [12-43])s, highest with the unstyletted tracheal tube; 60 s (60-60 [60, 60])s and styletted tracheal tube 60 s (29-60 [18-60])s, and intermediate with the directional stylet 21 s (15-60 [8-60])s. The use of a stylet alone does not confer benefit in the setting of easy laryngoscopy. However, in more difficult laryngoscopy scenarios, the C-MAC videolaryngoscope performs best when used with a stylet that angulates the distal tracheal tube. The hockey-stick stylet configuration performed best in the scenarios tested.
Funder
Publisher
Wiley-Blackwell
Publisher DOI
Rights
Attribution-NonCommercial-NoDerivs 3.0 Ireland
cbn
Collections
Externally hosted open access publications with University of Galway authors (2)