EMS Intubation Improves with King Vision Video Laryngoscopy

Area of Science:

• Emergency Medicine
• Medical Devices
• Airway Management

Background:

• Intubation success rates among paramedics are historically variable, with low first-pass success (FPS) linked to adverse events.
• Existing research on video laryngoscopy (VL) versus direct laryngoscopy (DL) for paramedics, particularly the King Vision device, shows conflicting results.
• This study addresses VL effectiveness in an emergency medical services (EMS) setting with low intubation frequency and historically poor success rates.

Purpose of the Study:

• To evaluate the impact of ongoing training with the King Vision VL on intubation success metrics.
• To compare first-pass success (FPS), overall success (OS), and success per attempt using VL versus DL in a suburban EMS system.
• To assess these outcomes in both cardiac arrest and other intubation indications.

Main Methods:

• Retrospective analysis of electronic patient care reports from a suburban EMS system.
• Comparison of intubation success metrics (FPS, OS, success per attempt) before DL and after VL implementation with ongoing training.
• Intention-to-treat analysis was performed to account for protocol deviations.

Main Results:

• Significant improvements were observed with VL compared to DL across all outcome measures: overall success (64.9% vs. 91.5%), first-pass success (43.8% vs. 74.2%), and success per attempt (44.4% vs. 71.2%).
• These improvements were consistent across subgroup analyses for all indications.
• An intention-to-treat analysis confirmed the enhanced success rates with VL.

Conclusions:

• The King Vision VL, coupled with an ongoing training program, significantly improved all measures of intubation success for paramedics in this EMS system.
• This approach is effective even in settings with historically low intubation success rates and infrequent procedures.
• The findings support the adoption of VL technology and structured training to enhance paramedic airway management.