Improvement in GlideScope® Video Laryngoscopy performance over a seven-year period in an academic emergency department

Abstract

To evaluate the outcomes in first pass success (FPS) of GlideScope (GVL) intubations over a seven-year period in an academic ED. Data were prospectively collected on all patients intubated in an academic ED with a level 1 trauma center over the seven-year period from July 1, 2007 to June 30, 2014. Following each intubation, the operator completed a standardized data collection form that included information on patient, operator and procedure characteristics. The primary outcome was first pass success, defined as successful intubation with a single laryngoscope blade insertion. The secondary outcome was the Cormack–Lehane (CL) view of the airway. To adjust for important confounders, a logistic regression model was used to determine the association between academic year and first pass success. In the first year of the study, the first pass success with the GVL was 75.6 % (68/90; 95 % CI 65.4–84.0 %) and the percentage of patients with CL I/II views was 95.6 % (86/90; 95 % CI 89.0–98.8 %). By the seventh year of the study, the first pass success with the GVL increased to 92.1 % (128/139; 95 % CI 86.3–96.0 %) and the percentage of patients with CL I/II views was 94.2 % (131/139; 95 % CI 89.0–97.5 %). In the logistic regression model, first pass success improved during the seven-year period (aOR 3.1; 95 % CI 1.3–7.1; p = 0.008). Over the seven-year period, there was significant improvement in the first pass success of the GVL, without any change in the Cormack–Lehane view, suggesting that there was improvement in the skill of tube delivery with use of the GVL over time.