Tracheal Intubation with a McGrath® Series 5 Video Laryngoscope by Novice Personnel in a Cervical-immobilized Manikin

Background Prehospital tracheal intubation may be performed by novice intubators in cervical immobilized patients. However, most indirect laryngoscopes require special training. The McGrath® Series 5 video laryngoscope is similar to the Macintosh laryngoscope in shape and usage, yet still confers the advantages of having indirect laryngoscopes. Objective This study compared tracheal intubation by novice users, using the McGrath® Series 5 video laryngoscope vs. the Macintosh laryngoscope in a cervical immobilized manikin. Methods Thirty-eight nurses intubated the trachea of a manikin using a McGrath® Series 5 video laryngoscope and a Macintosh laryngoscope, in random order. Then they repeated the procedure in a manikin with a cervical collar. Success rate, time to success, number of intubation attempts, dental clicks, and difficulty score were compared between the two laryngoscopes. Results First-attempt success rate was higher for the McGrath® Series 5 compared to the Macintosh laryngoscope in cervical immobilizations (84.2% vs. 47.7%, respectively; p = 0.019). However, overall intubation success rate with and without the cervical collar was no different. Tracheal intubation using the McGrath® Series 5 was faster than the Macintosh laryngoscope regardless of the presence of a cervical collar. McGrath® Series 5 required fewer trials, had fewer dental clicks, and was easier to use than the Macintosh laryngoscope. Conclusions McGrath® Series 5 video laryngoscope may be better than a standard Macintosh laryngoscope for novice intubators intubating the trachea in cervical immobilization, due to the higher first-attempt success rate, faster intubation time, fewer dental clicks, lower number of intubation attempts, and overall ease of use.