Park - Glidescope Intubation During Uninterrupted CPR

    The concept and practice of  " intubation during  uninterrupted CPR"  was demonstrated by Dr Marvin Wayne during exploration of application of the Glidescope Ranger to a Whatcom County Fire Ambulance Service service area population published in 2010 (1). Many patients in this study were in fact CPR patients and on a few the compressions were noted on video to be continuous during the intubation.
   The confirmation study has now been published by SO Park (2) who has published a landmark study in 09/25/2013 Rescusitation wherein it was shown that Glidescope intubation can be easily carried out without interruption of CPR. The importance of this finding is that the debate about how to manage airway during resuscitation is vaulted to a new level by readily available Glidescope technology.
The 60 degree angle of the Glidescope is important in that it allows easy airway viewing during the intubation as will be noted when viewing real time intubations carried out  by Fire service care givers. The adoption of Glidescope Video Laryngoscopy can substantially change the current management of airways during CPR.


Reference:
1. 

Comparison of Traditional versus Video Laryngoscopy in Out-of-Hospital Tracheal Intubation

Authors: Wayne, Marvin A.; McDonnell, Mannix

Source: Prehospital Emergency Care, Volume 14, Number 2, June 2010 , pp. 278-282(5)

 Results. The average time to intubate in the VL group was 21 seconds (range 8---43 seconds) versus 42 seconds (range 28---90 seconds) in the TL group. The average number of attempts was 1.2 (range 1---3) in the VL group versus 2.3 (range 1---4) in the TL group. Successful intubation was 97% in the VL group versus 95% in the TL group. There were no unrecognized misplaced tubes in either group. For failed intubations, an alternative airway was successful in 99% of the VL group and 99% of the TL group. Maximum nonventilated time during any one intubation attempt was 37 seconds in the VL group and 55 seconds in the TL group. Conclusions. The numbers of attempts were significantly reduced in the VL group. This suggests that the use of VL has a positive effect on the number of attempts to achieve tracheal intubation.

2.

Feasibility of the video-laryngoscope (GlideScope) for endotracheal intubation during uninterrupted chest compressions in actual advanced life support: A clinical observational study in an urban emergency department 
Source: Resuscitation, 09/25/2013  

Park SO et al. – This is the first clinical trial to evaluate whether successful endotracheal intubation (ETI) using a video–laryngoscope (VL) (GlideScope) can be performed easily without chest compression interruptions during actual cardiopulmonary resuscitation (CPR) after brief VL training, regardless of the physicians’ levels of experience with successful ETI in the past. In a clinical setting, the use of a VL had a high success rate for the first ETI attempt with notably few chest compression interruptions, regardless of the physicians’ varying experience with successful ETI in the past.