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.