Tracheal intubation following training with the GlideScope ® compared to direct laryngoscopy

SUMMARY: Tracheal intubation using direct laryngoscopy has a high failure rate when performed by untrained medical personnel. This study compares tracheal intubation following direct laryngoscopy by inexperienced medical students when initially trained by using either the GlideScope, a video assisted laryngoscope, or a rigid (Macintosh) laryngoscope. Forty-two medical students with no previous experience in tracheal intubation were randomly divided into two equal groups to receive training with the GlideScope or with direct laryngoscopy. Subsequently, each medical student performed three consecutive intubations on patients with normal airways that were observed by a anaesthetist who was blinded to the training method. The rates of successful intubation were significantly higher in the Glidescope group after the first (48%), second (62%), and third (81%) intubations compared with the Macintosh group (14%, 14% and 33%; p = 0.043, 0.004 and 0.004, respectively). The mean (SD) times for the first, second, and third successful tracheal intubations were significantly shorter in the Glidescope group (59.3 (4.4) s, 56.6 (7.1) s and 50.1 (4.0) s) than the Macintosh group (70.7 (7.5) s, 73.7 (7.3) s and 67.6 (2.0) s; p = 0.006, 0.003 and 0.0001, respectively). Training with a video-assisted device such as the GlideScope improves the success rate and time for tracheal intubation in patients with normal airways when this is performed by inexperienced individuals following a short training programme.