ABSTRACT
Background
Endotracheal tube delivery through the vocal cords can be challenging with hyperangulated
video laryngoscopy due to the acute angle around the tongue and surrounding airway
structures. Articulating video stylets may mitigate this issue by equipping an endotracheal
tube stylet with an operator-controlled articulating end that has an additional camera
at the tip.
Objectives
We compared operator-reported ease of intubation between the traditional rigid stylet
(GlideRite® Rigid Stylet, Verathon Inc., Bothell, WA) and the articulating video stylet
(ProVu™ Video Stylet, Flexicare Inc., Irvine, CA) with a hyperangulated video laryngoscope
(GlideScope®, Verathon Inc., Bothell, WA).
Methods
Participants performed simulated intubation using a hyperangulated video laryngoscope
with both stylets in random order. We compared operator-reported ease of intubation
on a 0-100 visual analog scale (VAS), best percentage of glottic opening (POGO), and
time to intubation. We compared outcomes using a paired t-test or the asymptotic Wilcoxon-Pratt
signed-rank test dependent on normality.
Results
We enrolled a convenience sample of 16 emergency department attendings, residents,
and physician assistant post-graduate trainees. The median operator-reported ease
of intubation on VAS was 20 (interquartile range 9, 30) for the rigid stylet and 20
(10, 30) for the articulating video stylet (p = 0.832). However, the rigid stylet
had a slightly shorter mean time to intubation compared to the articulating video
stylet, 6.9 (standard deviation 2.5) vs. 10.3 (4.1) seconds, respectively (p = 0.017).
POGO was similar between groups.
Conclusions
During simulated endotracheal intubation, the rigid and articulating video stylets
had similar operator-reported ease of intubation.
Keywords
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Article info
Publication history
Accepted:
January 6,
2023
Received in revised form:
December 6,
2022
Received:
August 6,
2022
Publication stage
In Press Accepted ManuscriptFootnotes
Financial Support: Supported by the Lake Erie College of Osteopathic Medicine (LECOM) and the Lake Erie Consortium for Osteopathic Medical Training (LECOMT) (Grant #J2020.22). Flexicare Inc. (Irvine, CA) provided one single-use ProVue® Video Stylet and lent a monitor to the study team.
Conflicts of Interest: None.
Author Contributions: All authors have made substantial contributions to the design, acquisition of data, analysis of data, and drafting of the manuscript.
Acknowledgements: This study was supported by the Lake Erie College of Osteopathic Medicine (LECOM) and the Lake Erie Consortium for Osteopathic Medical Training (LECOMT) (Grant #J2020.22).
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
