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VOLUME 7 , ISSUE 1 ( January-June, 2022 ) > List of Articles

Original Article

Introductory Session to Direct Laryngoscopy and Endotracheal Intubation for Medical Interns: Is Video-laryngoscopy a Useful Teaching Aid?

Madhavi Singh, Sushma Konduri, Nagalla Balakrishna

Keywords : Airway management, Direct laryngoscopy, Endotracheal intubation, Simulation, Video-laryngoscopy

Citation Information : Singh M, Konduri S, Balakrishna N. Introductory Session to Direct Laryngoscopy and Endotracheal Intubation for Medical Interns: Is Video-laryngoscopy a Useful Teaching Aid?. Res Inno Anesth 2022; 7 (1):10-13.

DOI: 10.5005/jp-journals-10049-2003

License: CC BY-NC 4.0

Published Online: 30-03-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Aim: Acquisition of basic and advanced airway skills on a mannequin is a well-accepted teaching methodology. To study the impact of video-laryngoscopy-aided identification of airway structures on basic skill acquisition by medical interns for endotracheal intubation (ETI) on a simulator was the aim. Materials and methods: This observational study was conducted in a simulation laboratory. Medical interns were randomized into conventional direct laryngoscopy (DL) and video-laryngoscope aided (VL) groups; they were taught DL and ETI with or without an additional video-laryngoscopy-based session. Participants performed an average of five supervised intubations, subsequent practical exam, and assessed by a blinded observer followed by submission of a structured questionnaire. Results: Eighty interns participated. The mean-time taken to intubate was 48.58 seconds and 48.65 seconds for the DL and VL groups, respectively. success in ETI in the first attempt was 90% (DL) and 87.5% (VL) (p = 0.72). Highest respect toward tissue in the DL group (p = 0.0730) was noted. Conclusion: Addition of video-laryngoscope as a teaching aid in the simulation laboratory did not affect intubation success rate or time. Clinical significance: • Teaching medical and technical skills to students using mannequins is a well-accepted methodology for hands-on experience and attaining proficiency. • Visualization of structures in video-laryngoscopy during endotracheal intubation is assumed to enhance success rate. However, success rate of intubation is independent of the technique used, that is, direct laryngoscopy and video-laryngoscopy. • Tissue respect is superior with direct laryngoscopy.

  1. Plummer JL, Owen H. Learning endotracheal intubation in a clinical skills learning center: a quantitative study. Anesth Analg 2001;93(3):656–662. DOI: 10.1097/00000539-200109000-00025
  2. Hempel G, Heinke W, Struck MF, et al. Impact of quantitative feedback via high-fidelity airway management training on success rate in endotracheal intubation in undergraduate medical students-a prospective single centre study. J Clin Med 2019;8(9):1465 DOI: 10.3390/jcm 8091465
  3. Lewis SR, Butler AR, Packer J, et al. Video-laryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation. Cochrane Database Syst Rev 2016;11(11).CDO111136. DOI: 10.1002/14651858.CD011136.pub2.
  4. Rothfield KP, Russo SG. Video-laryngoscopy: should it replace direct laryngoscopy? a pro-con debate. J Clin Anesth 2012;24(7):593–597. DOI: 10.1016/j.jclinane.2012.04.005
  5. Paolini JB, Donati F, Drolet P. Review article: video-laryngoscopy: another tool for difficult intubation or a new paradigm in airway management? Can J Anaesth 2013;60(2):184–191. DOI: 10.1007/s12630-012-9859-5.
  6. Maharaj CH, Costello JF, Higgins BD, et al. Learning and performance of tracheal intubation by novice personnel: a comparison of the Airtraq and Macintosh laryngoscope. Anaesthesia 2006;61(7):671–677. DOI: 10.1111/j.1365-2044.2006.04653.x
  7. Nouruzi-Sedeh P, Schumann M, Groeben H. Laryngoscopy via Macintosh blade versus GlideScope: success rate and time for endotracheal intubation in untrained medical personnel. Anesthesiology 2009;110(1):32–37. DOI: 10.1097/ALN.0b013e318190b6a7
  8. Ayoub CM, Kanazi GE, Al Alami A, et al. Tracheal intubation following training with the GlideScope compared to direct laryngoscopy. Anaesthesia 2010;65(7):674–678. DOI: 10.1111/j.1365-2044.2010.06335.x
  9. Downey AW, Duggan LV, Adam Law J. A systematic review of meta-analyses comparing direct laryngoscopy with video-laryngoscopy. Can J Anaesth 2021;68(5):706–714. DOI: 10.1007/s12630-021-01921-7
  10. van Zundert A, Pieters B, Doerges V, et al. Video-laryngoscopy allows a better view of the pharynx and larynx than classic laryngoscopy. Br J Anaesth 2012;109(6):1014–1015. DOI: 10.1093/bja/aes418
  11. Gu M, Lian M, Gong C, et al. The teaching order of using direct laryngoscopy first may improve the learning outcome of endotracheal incubation: a preliminary, randomized controlled trial. Medicine (Baltimore) 2019;98(21):e15624. DOI:10.1097/MD.0000000000015624
  12. Herbstreit F, Fassbender P, Haberl H, et al. Learning endotracheal intubation using a novel video-laryngoscope improves intubation skills of medical students. Anesth Analg 2011;113(3):586–590. DOI: 10.1213/ANE.0b013e3182222a66
  13. Mulcaster JT, Mills J, Hung OR, et al. Laryngoscopic intubation: learning and performance. Anesthesiology 2003;98(1):23–27. DOI: 10.1097/00000542-200301000-00007
  14. Toda J, Toda AA, Arakawa J. Learning curve for paramedic endotracheal intubation and complications. Int J Emerg Med 2013;6(1):38. DOI: 10.1186/1865-1380-6-38.
  15. Buis ML, Maissan IM, Hoeks SE, et al. Defining the learning curve for endotracheal intubation using direct laryngoscopy: a systematic review. Resuscitation 2016;99:63–71. DOI: 10.1016/j.resuscitation.2015.11.005
  16. Wong W, Kedarisetty S, Delson N, et al. The effect of cross-training with adjustable airway model anatomies on laryngoscopy skill transfer. Anesth Analg 2011;113(4):862–868. DOI: 10.1213/ANE.0b013e3181fe758b
  17. Weidman J, Baker K. The Cognitive Science of Learning: concepts and strategies for the educator and learner. Anesth Analg 2015;121(6):1586–1599. DOI: 10.1213/ANE.0000000000000890
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