Comparing Vie Scope® and Macintosh Laryngoscopes in Suspected/Confirmed COVID-19 Cardiac Arrest Patients Being Intubated by Paramedics: A Prospective Randomized Crossover Simulation Trial

Abstract

Aim: This study was designed with the aim of evaluating Vie Scope®’s role in placing an endotracheal tube (ETT) by paramedics wearing full personal protective equipment who are experienced in direct laryngoscopy but inexperienced in using the Vie Scope® for intubation. Material and Methods: Twenty-seven paramedics participated in this prospective, randomized, single-blinded crossover simulation trial using manikins. Participants performed endotracheal intubation on simulated adult cardiac arrest patients with suspected/confirmed COVID-19. During all procedure’s, paramedics wore Level C personal protective equipment (PPE). Primary endpoint was time to intubation (TTI). Results: Time to intubation using the Vie Scope was 43.5±12 seconds, statistically significantly faster than the Macintosh laryngoscope at 57.5±15.6 seconds (MD = -14.00; 95% CI [-21.42, -6.58]; p < 0.001). First pass success rate using the Vie Scope® and Macintosh laryngoscope was 88.9% and 63.0%, respectively (OR = 4.71; 95% CI [1.12, 19.70]; p = 0.03). The overall intubation success rate was 100% for each group. Conclusions: With paramedics wearing full PPE, the Vie Scope laryngoscope provided faster endotracheal intubation and a better first pass success rate than the Macintosh laryngoscope. Further studies involving clinical trials are necessary to confirm these results.