A prospective cohort evaluation of the McGrathTM MAC videolaryngoscope in a series of 979 cases

Background: Evidence favouring the effectiveness of videolaryngoscopes over conventional direct laryngoscopy for facilitating successful tracheal intubation has been growing. However, to choose be-tween different devices, clinicians need to know how individual devices perform outside of carefully controlled clinical trials.Aim: To evaluate the effectiveness of the McGrath MAC videolaryngoscope as it was introduced into clinical practice. Methods: Cohort evaluation of McGrath MAC videolaryngoscope use in clinical practice by voluntary completion of an evaluation form over a two-year period.Results: In a total of 979 cases, tracheal intubation was successful in 955/979 (97.5%), with first pass success achieved in 785/955 (82.2%). Most tracheal intubations (964/979, 80.1%) were performed during 'office hours' (Monday to Friday 0800-1800). Senior anaesthetists conducted 423/970 (43.6%) of in-tubations. There were 24/979 (2.5%) failed intubations, with consultants or senior anaesthetists con-ducting laryngoscopy in the majority of these;in 16/22 failed intubations, a grade I or II glottic view was obtained on the videolaryngoscope screen. Of the 20 anaesthetists involved as intubators, 14 had used the device fewer than 50 times.Conclusion: Our historical results demonstrate the effectiveness and feasibility of using the McGrath MAC videolaryngoscope to facilitate tracheal intubation in clinical practice. However, we believe the most important finding was the number of "easy" grade I and II glottic views on videolaryngoscopy where tracheal intubation was not achieved. Our experience and the evidence suggest that in order to fully realise the numerous benefits of videolaryngoscopy, the introduction of formal teaching and in-struction by trained trainers is essential. (c) 2022 Elsevier Ltd. All rights reserved.

Airway management in critically ill patients. From International Studies to Clinical Practice - A summary from an EAMS webinar

Airway management, including tracheal intubation and tracheostomy, is the most commonly performed procedure in critically ill patients. The EAMS held a webinar in June 2021 focused on this subject. Vincenzo Russotto from Monza, Italy and Sheila Myatra from Mumbai, India presented the results of the "INternational observational study To Understand the impact and BEst practices of airway management in critically ill patients", the INTUBE study. The attendees of the EAMS webinar asked questions related to the study and the complications in critically ill patients. The present article summarises the discussion together with strategies to help clinicians prevent and treat these complications. Copyright © 2021 Elsevier Ltd

A survey by the european airway management society (EAMS) about online education

Backgrounds and Aims: The outbreak of the COVID-19 pandemic led to cancellation of nearly all physical conferences and workshops over the past 18 months. ON-line educational activities were offered all over. To get insight about anaesthetics preferences online activities specifically on airway management, the European Airway Management Society (EMAS) carried out a members survey in July 2020. Method: An e-survey on 'google forms' was sent to all society members asking their willingness to attend virtual events hosted by EAMS. A five point Likert scale asked about their preferred presentation format, their interest on different airway management topics, duration and periodicity of such activities. Results: From 623 addressed members, 274 opened the email and 118 (19% and 43% respectively) answered. Interestingly, 90% of respondents would attend a virtual EAMS conference, 92% were interested in attending shorter webinars. The preferred formats were webinars, pro-con-debates and sessions including audience response system. Recorded lectures were the least wanted. High rated topics of interest were: airway guidelines and devices, challenging cases, education, apnoeic oxygenation and the shared airway (Fig. 1). Short 60 to 90 minutes sessions distributed over several days and monthly sessions were found convenient. Suggested topics from the respondents were: human factors in airway management, including non-technical skills and teamwork. Conclusion: This survey provided EAMS solid grounds to organize and spend resources on a series of gratis, open accessible and interactive webinars of 75 minutes duration from November 2020 on. In 2021, an audience of about 180 participants from 40 countries attended these monthly webinars given by internationally recognized speakers. Topics covered were tracheostomy care, patient's safety, awake intubation, high-flow nasal oxygen and COVID-19, airway management in critically ill adults: the INTUBE study, the NECTARINE and PEDI children studies, briefing and debriefing in airway management.

EAMS Webinar March 2021: Pragmatic guide to awake videolaryngoscope guided Intubation

Awake tracheal intubation remains the gold standard for managing a predicted difficult airway. There is emerging evidence that supports the use of videolaryngoscope guided awake intubation. Videolaryngoscopes have become widely available and consequently easy to use and familiar to anaesthetists, allowing for observed tube placement and fixed wide view of the glottis throughout the intubation procedure. This article summarizes the key points and provides answers to the main audience questions from the EAMS March 2021 Webinar. Topics discussed include optimal patient and operator positioning, techniques of applying topical anaesthesia to the airway, testing for adequacy of airway anaesthesia, videolaryngoscope blade insertion and tracheal tube placement and sedation for awake intubation.

The Italian coronavirus disease 2019 outbreak: recommendations from clinical practice.

Novel coronavirus 2019 is a single-stranded, ribonucleic acid virus that has led to an international pandemic of coronavirus disease 2019. Clinical data from the Chinese outbreak have been reported, but experiences and recommendations from clinical practice during the Italian outbreak have not. We report the impact of the coronavirus disease 2019 outbreak on regional and national healthcare infrastructure. We also report on recommendations based on clinical experiences of managing patients throughout Italy. In particular, we describe key elements of clinical management, including: safe oxygen therapy; airway management; personal protective equipment; and non-technical aspects of caring for patients diagnosed with coronavirus disease 2019. Only through planning, training and team working will clinicians and healthcare systems be best placed to deal with the many complex implications of this new pandemic.