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Learning Objective 1: The learner will be able to identify the pitfalls of conventional laryngoscopy versus video guided laryngoscopy as they relate to successful emergency department intubations.
Learning Objective 2: The learner will be able identify the reasons for emergency department intubations as an important emergency airway and breathing intervention.
METHODS: A sampling plan was established in the extraction of literature using these key terms: emergency, difficult, paramedic, novice, indirect view, video, optical, direct view, conventional, Macintosh, intubation or induction, comparison. A database search was performed from Clinical Evidence BMJ, CINAHL, Cochrane Library, Essential Evidence Plus, Health Reference Center-Academic, JBI COnNECT+, MEDLINE National Guidelines Clearinghouse, and PubMed. Inclusion criteria involved publications from 2005-2013. Each study was evaluated for its strength of evidence using the Johns Hopkins Nursing Evidence-Based Practice Research Evidence Appraisal Tool.
RESULTS: Twelve studies were collected; 2 were eliminated due to relevance and 2 for poor quality. Based on the 8 studies used, VGL out-performed CL, especially in difficult intubations. One study of low quality was inconclusive.
CONCLUSION: Video laryngoscopes may offer a more efficient alternative to conventional intubation equipment in the ED, especially with challenging airways. IMPLICATIONS: Considering the difficulties often faced in emergency conditions, finding the best method to intubate is essential to providing the best standard of care. Recommendations include: 1) Conduct a case-control study within the ED, 2) Provide ongoing training to gain and maintain familiarity and skill in using VGL, and 3) Establish quality assessment indicators to continually monitor outcomes and eventually adherence to any new recommendations.
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