[Videolaryngoscopic endotracheal intubation during out-of-hospital cardiac arrest from the perspective of paramedics : Training requirements and subjective procedural confidence-results of an anonymous cross-sectional survey].

Abstract

Background: Videolaryngoscopic endotracheal intubation (VL_ETI) was implemented as a structured training module for paramedics as part of an annual continuing education program in a German EMS system. The aim was not to evaluate intubation success rates, but rather to assess perceived training needs and subjective confidence in the application of the technique.

Methods: An anonymous online cross-sectional survey was conducted among participants of the 2025 training program. Only datasets from paramedics were included in the analysis. Subjective confidence in five airway management techniques was ranked using a Borda score (rank 1 = 5 points, rank 5 = 1 point).

Results: Seventy-nine paramedics participated (62.7%). The iGel® achieved 336 of a maximum of 395 points. Macintosh-like VL_ETI with stylet and with bougie each reached 256 points. Hyperangulated techniques scored considerably lower (171 and 166 points). About half of the participants reported a need for more frequent training.

Conclusions: Although VL_ETI was generally well accepted, its perceived safety remained lower than that of supraglottic airway devices. These findings support structured, repeated, and quality-assured training approaches rather than an uncontrolled expansion of invasive airway techniques.