Evidence map›Paper›PMID 31389835›Full record

Trial reportCritical care medicine2019

Comparing the McGrath Mac Video Laryngoscope and Direct Laryngoscopy for Prehospital Emergency Intubation in Air Rescue Patients: A Multicenter, Randomized, Controlled Trial.

Janett Kreutziger, Sonja Hornung, Clemens Harrer, Wilhelm Urschl, Reinhard Doppler, Wolfgang G Voelckel, Helmut Trimmel

Open access · hybridAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Critical care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 4 pooled it
4.2field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 4 syntheses or guidelines pooled it, 35 citations in OpenAlex.

  1. Pooled it
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  13. Rapid sequence induction: where did the consensus go?Scandinavian journal of trauma, resuscitation and emergency medicine · 2021
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Janett KreutzigerDepartment of General and Surgical Critical Care Medicine, Medical University of Innsbruck, Innsbruck, Austria.
Sonja HornungDepartment of Anesthesiology, Emergency and Critical Care Medicine, Wiener Neustadt General Hospital, Wiener Neustadt, Austria.
Clemens HarrerOEAMTC Air Rescue, Vienna, Austria.
Wilhelm UrschlOEAMTC Air Rescue, Vienna, Austria.
Reinhard DopplerOEAMTC Air Rescue, Vienna, Austria.
Wolfgang G VoelckelOEAMTC Air Rescue, Vienna, Austria.
Helmut TrimmelDepartment of Anesthesiology, Emergency and Critical Care Medicine, Wiener Neustadt General Hospital, Wiener Neustadt, Austria.
Medical University of Vienna · ATUniversität Innsbruck · ATUniversity of Stavanger · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTracheal intubation in prehospital emergency care is challenging. The McGrath Mac Video Laryngoscope (Medtronic, Minneapolis, MN) has been proven to be a reliable alternative for in-hospital airway management. This trial compared the McGrath Mac Video Laryngoscope and direct laryngoscopy for the prehospital setting.

designMulticenter, prospective, randomized, controlled equivalence trial.

settingOesterreichischer Automobil- und Touring Club (OEAMTC) Helicopter Emergency Medical Service in Austria, 18-month study period. PATIENTS: Five-hundred fourteen adult emergency patients (≥ 18 yr old).

interventionsHelicopter Emergency Medical Service physicians followed the institutional algorithm, comprising a maximum of two tracheal intubation attempts with each device, followed by supraglottic, then surgical airway access in case of tracheal intubation failure. No restrictions were given for tracheal intubation indication. MEASUREMENTS MAIN

resultsThe Primary outcome was the rate of successful tracheal intubation; equivalence range was ± 6.5% of success rates. Secondary outcomes were the number of attempts to successful tracheal intubation, time to glottis passage and first end-tidal CO2 measurement, degree of glottis visualization, and number of problems. The success rate for the two devices was equivalent: direct laryngoscopy 98.5% (254/258), McGrath Mac Video Laryngoscope 98.1% (251/256) (difference, 0.4%; 99% CI, -2.58 to 3.39). There was no statistically significant difference with regard to tracheal intubation times, number of attempts or difficulty. The view to the glottis was significantly better, but the number of technical problems was increased with the McGrath Mac Video Laryngoscope. After a failed first tracheal intubation attempt, immediate switching of the device was significantly more successful than after the second attempt (90.5% vs 57.1%; p = 0.0003), regardless of the method.

conclusionsBoth devices are equivalently well suited for use in prehospital emergency tracheal intubation of adult patients. Switching the device following a failed first tracheal intubation attempt was more successful than a second attempt with the same device.

Indexed as

Emergency Medical ServicesAdolescentAdultAgedAged, 80 and overAir AmbulancesFemaleHumansIntubation, IntratrachealLaryngoscopesLaryngoscopyMaleMiddle AgedProspective StudiesVideo RecordingYoung Adult

Identifiers

PMID31389835
PMCPMC6791500
OpenAlexW2968689138

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.