A Comparison of the C-MAC Video Laryngoscope to the Macintosh Direct Laryngoscope for Intubation in the Emergency Department
Annals of Emergency Medicine,  Clinical Article

Sakles JC et al. – When used for emergency intubations in the emergency department (ED), the C–MAC was associated with a greater proportion of successful intubations and a greater proportion of Cormack–Lehane grade I or II views compared with a direct laryngoscope.

Methods
  • This was a retrospective analysis of prospectively collected data entered into a continuous quality improvement database during a 28–month period in an academic ED.
  • After each intubation, the operator completed a standardized data form evaluating multiple aspects of the intubation, including patient demographics, indication for intubation, device(s) used, reason for device selection, difficult airway characteristics, number of attempts, and outcome of each attempt.
  • Intubation was considered ultimately successful if the endotracheal tube was correctly inserted into the trachea with the initial device.
  • An attempt was defined as insertion of the device into the mouth regardless of whether there was an attempt to pass the tube.
  • The primary outcome measure was ultimate success.
  • Secondary outcome measures were first–attempt success, Cormack–Lehane view, and esophageal intubation.
  • Multivariate logistic regression analyses, with the inclusion of a propensity score, were performed for the outcome variables ultimate success and first–attempt success.

Results
  • During the 28–month study period, 750 intubations were performed with either the C–MAC with a size 3 or 4 blade or a direct laryngoscope with a Macintosh size 3 or 4 blade.
  • Of these, 255 were performed with the C–MAC as the initial device and 495 with a Macintosh direct laryngoscope as the initial device.
  • The C–MAC resulted in successful intubation in 248 of 255 cases (97.3%; 95% confidence interval [CI] 94.4% to 98.9%).
  • A direct laryngoscope resulted in successful intubation in 418 of 495 cases (84.4%; 95% CI 81.0% to 87.5%).
  • In the multivariate regression model, with a propensity score included, the C–MAC was positively predictive of ultimate success (odds ratio 12.7; 95% CI 4.1 to 38.8) and first–attempt success (odds ratio 2.2; 95% CI 1.2 to 3.8).
  • When the C–MAC was used as a video laryngoscope, a Cormack–Lehane grade I or II view (video) was obtained in 117 of 125 cases (93.6%; 95% CI 87.8% to 97.2%), whereas when a direct laryngoscope was used, a grade I or II view was obtained in 410 of 495 cases (82.8%; 95% CI 79.2% to 86.1%).
  • The C–MAC was associated with immediately recognized esophageal intubation in 4 of 255 cases (1.6%; 95% CI 0.4% to 4.0%), whereas a direct laryngoscope was associated with immediately recognized esophageal intubation in 24 of 495 cases (4.8%; 95% CI 3.1% to 7.1%).

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Otolaryngology

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Otolaryngology Articles

1 The effectiveness of nasal saline irrigation (seawater) in treatment of allergic rhinitis in children International Journal of Pediatric Otorhinolaryngology , June 12, 2014    Clinical Article

2 The role of antibiotic therapy and nasal packing in septoplasty European Archives of Oto-Rhino-Laryngology, April 8, 2014    Review Article

3 Sublingual five-grass pollen tablets (Oralair): a guide to their use as allergen immunotherapy for grass pollen-induced allergic rhinoconjunctivitis Drugs & Therapy Perspectives, June 2, 2014    Clinical Article

4 The role of a Mediterranean diet on the risk of oral and pharyngeal cancer British Journal of Cancer, June 24, 2014    Clinical Article

5 Endolaryngeal dilatation versus laryngotracheal reconstruction in the primary management of subglottic stenosis International Journal of Pediatric Otorhinolaryngology , June 13, 2014    Clinical Article

6 A double blind randomised placebo-controlled trial of topical intranasal mometasone furoate nasal spray in children of adenoidal hypertrophy with otitis media with effusion American Journal of Otolaryngology, June 26, 2014    Clinical Article

7 Quality of life after surgery for recurrent otitis media in a randomized controlled trial The Pediatric Infectious Disease Journal, June 17, 2014    Clinical Article

8 T3-T4 larynx cancer in the Netherlands Cancer Institute; 10-year results of the consistent application of an organ preserving/sacrificing protocol Head & Neck, June 4, 2014

9 Postoperative outcomes in Coblation versus electrocautery tonsillectomies Full Text International Journal of Otolaryngology and Head & Neck Surgery, March 12, 2014    Free full text    Clinical Article

10 Cigarette smoking, passive smoking, alcohol consumption, and hearing loss Journal of the Association for Research in Otolaryngology, June 6, 2014    Clinical Article
Exclusive Author Commentary

11 Reflexive culture in adolescents and adults with group a streptococcal pharyngitis Clinical Infectious Diseases, June 5, 2014    Clinical Article

12 Otitis media: An update on current pharmacotherapy and future perspectives Expert Opinion on Pharmacotherapy, May 22, 2014    Clinical Article

13 Safety and tolerability of a short ragweed sublingual immunotherapy tablet Annals of Allergy, Asthma, and Immunology, June 3, 2014    Clinical Article

14 Predictive factors for quality of life after tonsillectomy among adults with recurrent pharyngitis: a prospective cohort study Clinical Otolaryngology, May 29, 2014    Clinical Article

15 Medication associated with hearing loss: 25 years of medical malpractice cases in the United States Otolaryngology - Head and Neck Surgery, June 12, 2014    Clinical Article

16 Folate intake and the risk of oral cavity and pharyngeal cancer: A pooled analysis within the INHANCE Consortium International Journal of Cancer, June 27, 2014    Clinical Article

17 Growth velocity reduced with once-daily fluticasone furoate nasal spray in prepubescent children with perennial allergic rhinitis The Journal of Allergy and Clinical Immunology: In Practice, June 16, 2014    Clinical Article

18 A trial of treatment for acute otorrhea in children with tympanostomy tubes New England Journal of Medicine, February 21, 2014    Evidence Based Medicine    Clinical Article

19 Effect of metformin on the incidence of head and neck cancer in diabetes Head & Neck, May 8, 2014    Clinical Article

20 Findings of chronic sinusitis on brain computed tomography are not associated with acute headaches The Journal of Emergency Medicine, June 4, 2014    Review Article

Indexed Journals in Otolaryngology: American Journal of Otolaryngology, Clinical Otolaryngology, Auris Nasus Larynxmore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close