King Vision VL vs Macintosh DL in novice intubators

Just this month in Journal of Anesthesia came out this mannikin study on novice intubators using King Vision VL vs Macintosh DL.

Here is the article

Comparison of intubation performance between the King Vision and Macintosh laryngoscopes in novice personnel: a randomized, crossover manikin study

Some interesting points to note:

  1. Success rates for intubation did not differ significantly for the channeled King Vision blade and Macintosh DL technique but the non channeled KV blade was worse for novice intubators in this study. This highlights issues of tube delivery with indirect laryngoscopes like the KV, Glidescope etc.
  2. Oesophageal intubations were only the problem with Macintosh DL. None occurred with the King Vision groups. Great safety point for novice intubators!
  3. For remote providers, say doctors, nurses or paramedics working in remote areas who will only very occasionally need to intubate, having a device like the King Vision is a reasonable option, especially in regard to avoiding oesophageal intubations.
2 Comments
  1. Confirms earlier studies: channelled VLs like the King Vision and the Pentax AWS are easier to use in difficult airways, compared to non-channeled. This probably reflects difficulties in manipulating a sharply angled ETT (particularly hard in the Glidescope). However the channel reduces the room for a Yankauer. The Pentax has a second channel for a 12FG suction catheter but it requires forethought to load this. How do you provide suction with a King Vision?

    • thanks Jo. you just reminded me to post our Twitter initiated bet on VL vs DL by 2020, so thanks!

      suction via KV?
      1. suction catheter along blade of KV , operated by assistant watching screen as well. allows intubator to focus on larynx acquisition.
      2. Suction via ETT using mec aspirator connector and ETT loaded onto KV ( not my preferred as dont want to deliberately stick camera end of KV into vomit/blood..albeit it seemed to work well despite doing this in fake blood simulated airway model!)

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