Videolaryngoscopy for intubation skills training of novice military airway managers

An estimated 10% of preventable battlefield deaths are due to Airway obstruction. Improved airway rescue strategies are needed with new tools for airway management by less experienced providers. Airway management and training are improved using video laryngoscopy (VL) compared to direct laryngoscopy (DL). We evaluated if novices could rapidly acquire fundamental skills and compared intubation time and laryngeal visualization using VL compared to DL in a manikin model of normal laryngeal anatomy. For 43 subjects mean intubation time did not differ for DL (25.9 +/- 24.5 seconds) vs. VL (26.4 +/- 31.5 seconds) {p = 0.94 paired t-test}. Self reported novice intubation time was 6.82 +/- 31.0 seconds greater with VL (31.6 +/- 34.6 seconds) vs. DL (24.8 +/- 18.5 seconds) {p = 0.255 paired t-test}. VL vs. DL time difference was not different between self-reported novice and non-novice groups. Mean Cormack-Lehane airway visualization grades (range 1-4) were higher with VL (1.95 +/- 0.97) vs. DL (1.02 +/- 0.15) {Students t-test p < 0.0001}. VL (69.7%) was preferred to DL (18.6%); no preference was indicated by 11.6%.