Internal and Emergency Medicine

, Volume 12, Issue 1, pp 91–97 | Cite as

Comparison of Macintosh, McCoy and C-MAC D-Blade video laryngoscope intubation by prehospital emergency health workers: a simulation study

  • Ahmet YildirimEmail author
  • Hasan A. Kiraz
  • İbrahim Ağaoğlu
  • Okhan Akdur


The aim of the this study is to evaluate the intubation success rates of emergency medical technicians using a Macintosh laryngoscope (ML), McCoy laryngoscope (MCL), and C MAC D-Blade (CMDB) video laryngoscope on manikin models with immobilized cervical spines. This randomized crossover study included 40 EMTs with at least 2 years’ active service in ambulances. All participating technicians completed intubations in three scenarios—a normal airway model, a rigid cervical collar model, and a manual in-line cervical stabilization model—with three different laryngoscopes. The scenario and laryngoscope model were determined randomly. We recorded the scenario, laryngoscope method, intubation time in seconds, tooth pressure, and intubation on a previously prepared study form. We performed Friedman tests to determine whether there is a significant change in the intubation success rate, duration of tracheal intubation, tooth pressure, and visual analog scale scores due to violations of parametric test assumptions. We performed the Wilcoxon test to determine the significance of pairwise differences for multiple comparisons. An overall 5 % type I error level was used to infer statistical significance. We considered a p value of less than 0.05 statistically significant. The CMDB and MCL success rates were significantly higher than the ML rates in all scenario models (p < 0.05). The CMDB intubation duration was significantly shorter when compared with ML and MCL in all models. CMDB and MCL may provide an easier, faster intubation by prehospital emergency health care workers in patients with immobilized cervical spines.


Intubation Prehospital Laryngoscope Video Manikin 



We would like to thank Dr. Şule Yıldırım for providing statistical analysis and Dr. Şükrü Kabaş for invaluable logistical support.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Funding source

No external funding was secured for this study.

Financial disclosure

The authors have no financial relationships relevant to this article to disclose.

Statement of human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© SIMI 2016

Authors and Affiliations

  • Ahmet Yildirim
    • 1
    Email author
  • Hasan A. Kiraz
    • 2
  • İbrahim Ağaoğlu
    • 1
  • Okhan Akdur
    • 1
  1. 1.Department of Emergency Medicine, Faculty of MedicineÇanakkale Onsekiz Mart UniversityKepezTurkey
  2. 2.Department of Anesthesiology and Reanimation, Faculty of MedicineÇanakkale Onsekiz Mart UniversityÇanakkaleTurkey

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