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| Superior view
A number of studies have shown that use of a video laryngoscope can improve the glottic view, including the Cochrane review ‘Videolaryngoscopy versus direct laryngoscopy for patients requiring tracheal intubation’1. In the case of video laryngoscopes with a Macintosh type blade such as the i-view™, this maybe due to the increased field of view provided by having a camera located on the blade of the device and the larger image on the screen.
Reduction in the number of failed intubations There is evidence that video laryngoscopy can reduce the number of failed intubations1, including where there is a predicted difficult airway.
Higher 1st time insertion success rates A 2014 study entitled, 'Video laryngoscopy versus direct laryngoscopy for orotracheal intubation in the ICU: a systematic review and meta-analysis’, analysed the data from nine studies with a total of 2,133 participants2. The review and meta-analysis provided evidence that video laryngoscopy improved first attempt success in the critical care setting.
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Lower rates of oesophageal intubation
A 2015 study investigating the use of a video laryngoscope by Emergency Medicine (EM) residents in the Emergency Department (ED) in a hospital in Arizona concluded that, ‘The use of a video laryngoscope by EM residents during an intubation attempt in the ED was associated with significantly fewer esophageal intubations compared to when a DL was used’3.
Reduced laryngeal/airway trauma Using a video laryngoscope can reduce the level of laryngeal/airway trauma1. A contributory factor to this reduction may be the reduced force that is generally required when using a video laryngoscope compared to a direct laryngoscope.
Improved team performance and training When a direct laryngoscope is being used, only the operator can see the view obtained. This makes it very difficult for other team members to understand the nature of any difficulty experienced and to provide optimal and timely assistance. In such circumstances, intubation is in effect a ‘solo event’. With video laryngoscopy, the screen, whether mounted on the device itself or on a separate monitor, can be seen by other members of the team, allowing them to understand the nature of any difficulty encountered and provide appropriate assistance. This changes intubation to a ‘team event’. Video laryngoscopy also assists training, since the trainer can see on the screen what is being visualised by the trainee whilst they perform laryngoscopy, allowing the trainer to provide advice and guidance as necessary.
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