Comparison of the GlideScope video laryngoscope and Macintosh laryngoscope in simulated tracheal intubation scenarios

Objective: To compare the GlideScope video laryngoscope (GVL) with the classic Macintosh laryngoscope in simulated airway scenarios of varying difficulty. Materials and methods: A prospective, crossover and randomised study was performed. Four airway scenarios were simulated using the Airsim model as follows: normal; cervical spine immobilisation; tongue oedema and combined cervical spine immobilisation with tongue oedema. Emergency physicians performed tracheal intubations using both devices in each of the scenarios. The time required to intubate, the success rate and the number of intubation attempts were recorded. At the end of each scenario, participants scored vocal cord visualisation using the percentage of glottic opening (POGO) visible and the subjective ease of intubation on a visual analogue scale (VAS). Results: All 25 participants successfully completed the study. There was no difference in the time required for successful tracheal intubation using the GVL compared with using the Macintosh laryngoscope in the four airway scenarios. Only one participant failed to intubate the trachea with the Macintosh laryngoscope for the combined scenario. There was a significant increase in POGO when using the GVL in the cervical spine immobilisation group (p = 0.027). The VAS score of the subjective ease of intubation was lower for the GVL than for the Macintosh laryngoscope device in difficult scenarios but this difference was not significant. Conclusion: This study suggests that the GVL could be an option for airway management even by emergency physicians with little experience and no training in its use.