Accuracy of a smartphone to test laryngoscope's light and an audit to our laryngoscopes using an ISO standard / Precisão de um smartphone para testar a luz de laringoscópio e uma auditoria de nossos laringoscópios usando as normas da ISO

Abstract Background and objectives: Laryngoscope is a key tool in anesthetic practice. Direct laryngoscopy is a crucial moment and inadequate laryngoscope's light can lead to catastrophic consequences. From our experience laryngoscope's light is assessed in a subjective manner and we believe a more precise evaluation should be used. Our objective is to compare the accuracy of a smartphone compared to a lux meter. Secondly we audited our Operating Room laryngoscopes. Methods: We designed a pragmatic study, using as primary outcome the accuracy of a smartphone compared to the lux meter. Further we audited with both the lux meter and the smartphone all laryngoscopes and blades ready to use in our Operating Rooms, using the International Standard form the International Organization for Standardization. Results: For primary outcome we found no significant difference between devices. Our audit showed that only 2 in 48 laryngoscopes complied with the ISO norm. When comparing the measurements between the lux meter and the smartphone we found no significant difference. Discussion: Ideally every laryngoscope should perform as required. We believe all laryngoscopes should have a practical but reliable and objective test prior to its utilization. Our results suggest the smartphone was accurate enough to be used as a lux meter to test laryngoscope's light. Audit results showing only 4% comply with the ISO standard are consistent with other studies. Conclusion: The tested smartphone has enough accuracy to perform light measurement in laryngoscopes. We believe this is a step further to perform an objective routine check to laryngoscope's light.

Resumo Justificativa e objetivo: O laringoscópio é uma ferramenta essencial na prática anestésica. A laringoscopia direta é um momento crucial e uma luz inadequada do laringoscópio pode levar a consequências catastróficas. De acordo com nossas pesquisas, a luz do laringoscópio é avaliada de forma subjetiva e acreditamos que uma avaliação mais precisa deve ser feita. Nosso objetivo foi comparar a precisão de um smartphone com a de um luxímetro. Depois, fizemos uma auditoria de nossos laringoscópios em sala de operação. Métodos: Estudo pragmático com o uso como desfecho primário da precisão de um smartphone em comparação com a de um luxímetro. Subsequentemente, fizemos uma auditoria tanto no luxímetro quanto com o smartphone de todos os laringoscópios e lâminas prontos para uso em nossas salas de cirurgia, usando as normas da International Organization for Standardization (ISO). Resultados: Para o desfecho primário não encontramos diferença significativa entre os dispositivos. Nossa auditoria mostrou que apenas dois em 48 laringoscópios satisfizeram as normas da ISO. Ao comparar as mensurações entre o luxímetro e o smartphone, não encontramos diferença significativa. Discussão: Idealmente, todos os laringoscópios deviam funcionar conforme previsto. Acreditamos que todos os laringoscópios devem ser submetidos a um teste prático, mas confiável e objetivo, antes de serem usados. Nossos resultados sugerem que o smartphone foi preciso o suficiente para ser usado como um luxímetro para testar a luz do laringoscópio. Os resultados da auditoria, que mostraram apenas 4% de conformidade com as normas da ISO corroboram os de outros estudos. Conclusão: O smartphone testado tem precisão suficiente para fazer a medição de luz em laringoscópios. Acreditamos que esse é um passo adiante na execução de uma verificação objetiva de rotina da luz do laringoscópio.

Comparison of the TruView infant EVO2 PCD and C-MAC video laryngoscopes with direct Macintosh laryngoscopy for routine tracheal intubation in infants with normal airways

OBJECTIVE: Videolaryngoscopy has mainly been developed to facilitate difficult airway intubation. However, there is a lack of studies demonstrating this method's efficacy in pediatric patients. The aim of the present study was to compare the TruView infant EVO2 and the C-MAC videolaryngoscope with conventional direct Macintosh laryngoscopy in children with a bodyweight ≤10 kg in terms of intubation conditions and the time to intubation. METHODS: In total, 65 children with a bodyweight ≤10 kg (0-22 months) who had undergone elective surgery requiring endotracheal intubation were retrospectively analyzed. Our database was screened for intubations with the TruView infant EVO2, the C-MAC videolaryngoscope, and conventional direct Macintosh laryngoscopy. The intubation conditions, the time to intubation, and the oxygen saturation before and after intubation were monitored, and demographic data were recorded. Only children with a bodyweight ≤10 kg were included in the analysis. RESULTS: A total of 23 children were intubated using the C-MAC videolaryngoscope, and 22 children were intubated using the TruView EVO2. Additionally, 20 children were intubated using a standard Macintosh blade. The time required for tracheal intubation was significantly longer using the TruView EVO2 (52 sec vs. 28 sec for C-MAC vs. 26 sec for direct LG). However, no significant difference in oxygen saturation was found after intubation. CONCLUSION: All devices allowed excellent visualization of the vocal cords, but the time to intubation was prolonged when the TruView EVO2 was used. The absence of a decline in oxygen saturation may be due to apneic oxygenation via the TruView scope and may provide a margin of safety. In sum, the use of the TruView by a well-trained anesthetist may be an alternative for difficult airway management in pediatric patients. .