New Versus Old, The i-View Video Laryngoscope Versus the GlideScope: A Prospective, Randomized, Crossover Trial.

Abstract

Background: A novel video laryngoscope device, the i-view, may extend intubation capability to the lowest echelons of deployed military medicine. The i-view is a one-time use, disposable laryngoscope. We compared time to completion of endotracheal intubation (ETI) between the i-view and GlideScope among military emergency medicine providers in a simulation setting.

Methods: We conducted a prospective, randomized, crossover trial. We randomized participants to i-view or GlideScope first before they performed 2 ETI-1 with each device. The primary outcome was time to completion of ETI. Secondary outcomes included first-pass success, optimal glottic view, and end-user appraisal. We used a Laerdal Airway Management Trainer for all intubations.

Results: Thirty-three emergency medicine providers participated. ETI time was less with GlideScope than i-view (22.2 +/- 9.0 seconds versus 30.2 +/- 24.0 seconds; p=0.048). Optimal glottic views, using the Cormack-Lehan scale, also favored the GlideScope (2 [1,2] versus 2[2,2]; p=0.044). There was no difference in first-pass success rates (100% versus 100%). More participants preferred the GlideScope (24 versus 9; p=0.165); however, participants agreed that the i-view would be easier to use than the GlideScope in an austere environment (4[4,5]).

Conclusions: We found the GlideScope outperformed the i-view with respect to procedural completion time. Participants preferred the GlideScope over i-view, but indicated the i-view would be easier to use than the GlideScope in an austere setting. Our findings suggest the i-view may be a suitable alternative to GlideScope for US military providers, especially for those in the prehospital setting.