Mary A. Bernhagen

Endotracheal intubation in a medical transport helicopter - comparing direct laryngoscopy with the prototype Storz CMAC videolaryngoscope in a simulated difficult intubating position.

This pilot study examined backward intubation of the Laerdal Difficult Airway Manikin in a medical transport helicopter using the prototype (a new more compact) Storz CMAC videolaryngoscope. The standard manikin airway Cormack Lehane (CL) view scores were 2.00 +/- 1.00 for direct view and 1.375 +/- 0.517 for the indirect view (CMAC). Success rates for backward intubation in the standard airway were 100% (CMAC) and 87.5% (DV). Average CL grades in the difficult airway were 3.63 +/- 0.74 (DV) and 2.00 +/- 0.926 (CMAC)(p = 0.002). The success rates for backward intubation of the difficult airway were 12.5% (DV) and 63% (CMAC). Our results show that in backward intubation of the difficult airway in a helicopter setting, the prototype CMAC videolaryngoscope significantly improved the airway score by 1-2 grades and improved intubation success 5-fold. Studies using the portable CMAC videolaryngoscope under challenging rescue conditions and positions should be considered.

Endotracheal intubation comparing a prototype Storz CMAC and a glidescope videolaryngoscope in a medical transport helicopter - a pilot study.

In this pilot study, experienced medical helicopter personnel evaluated and compared the prototype Storz CMAC and GlideScope (GS) videolaryngoscopes in intubating a Laerdal Difficult Airway Manikin in a helicopter. No significant differences were found between the devices in the standard airway mode with 100% success rates for the intubations. In the difficult airway mode, there was a significant difference (p = 0.03) between the Cormack Lehane scores observed with Direct View (DV) (3.75 +/- 0.46 - average +/- standard deviation) compared to the view with the prototype CMAC (2.25 +/- 0.71). The view was 3.00 +/- 0.76 with GS In the difficult airway, there were significantly more participants who obtained a Grade 1 or 2 view when using the CMAC compared to when using the Mac 3 blade (DV) (p = 0.025; Fisher Exact Probability Test). The success rate for intubating the difficult airway was 0% with DV; compared to 63% with the CMAC and 50% with the GS (p = 0.03). The participants answered a post study questionnaire regarding the characteristics of the devices and indicated preference for the CMAC over the GS in intubation of the difficult airway.

Nasotracheal intubation in a difficult airway using the Storz C-MAC Videolaryngoscope, the Boedeker Bougie endotracheal introducer, and the Boedeker curved forceps.

Airway management has multiple indications for nasotracheal intubation. In this study, we focus on its indication in difficult airways. This work describes a modified procedure of nasotracheal intubation using the new Storz CMAC® Videolaryngoscope, the malleable Boedeker Bougie and the curved Boedeker Forceps in the intubation of a difficult airway manikin.

Using the Battlefield Telemedicine System (BTS) to train deployed medical personnel in complicated medical tasks - a proof of concept.

This work describes the use of Adobe Connect software along with algorithm software to provide the necessary audio visual communication platform for telementoring a complex medical procedure to novice providers located at a distant site.

A comparison of an integrated suction blade versus a traditional videolaryngoscope blade in the endotracheal intubation of a hemorrhagic cadaver model - a pilot study.

In this pilot study, we evaluated two types of videolaryngoscope blades (integrated suction vs. traditional) with the Storz CMAC videolaryngoscope in the intubation of a lightly embalmed hemorrhagic cadaver model. No significant differences were found between the devices in the success rates for the intubations. The study subjects indicated a preference for the integrated suction blade in hemorrhagic airway intubation.

Combined Intubation Training (Simulated and Human) for 4 th Year Medical Students: The Center for Advanced Technology and Telemedicine Airway Training Program

The video laryngoscope is a useful tool in intubation training as it allows both the trainer and the student to share the same view of the airway during the intubation process. In this study, the Center for Advanced Technology and Telemedicines airway training program employed videolaryngoscopy (VL) in teaching both simulated (manikin) and human intubation. The videolaryngoscope statistically improved the glottic view in both the standard and difficult manikin airways when compared to that with standard (direct) laryngoscopy. The success rate in simulated difficult airway intubation was significantly improved using VL. With human intubation training, there was statistically significant improvement in airway views using VL and a 97.5% intubation success rate. The enhanced view of the videolaryngoscope in airway intubation facilitates the learning process in performing both simulated and human intubation, making it a powerful tool in intubation training.

Battlefield tracheal intubation training using virtual simulation: A multi center operational assessment of video laryngoscope technology

Airway management is an essential skill in providing care in trauma situations. The video laryngoscope is a tool which offers improvement in teaching airway management skills and in managing airways of trauma patients on the far forward battlefield. An Operational Assessment (OA) of videolaryngoscope technology for medical training and airway management was conducted by the Center for Advanced Technology and Telemedicine (at the University of Nebraska Medical Center, Omaha, NE) for the US Air Force Modernization Command to validate this technology in the provision of Out of OR airway management and airway management training in military simulation centers. The value for both the training and performance of intubations was highly rated and the majority of respondents indicated interest in having a video laryngoscope in their facility.

Use of a malleable bougie and curved forceps with videolaryngoscopy in airway management training in a cadaver model- A pilot study

The wider angle of view of videolaryngoscopy versus standard direct laryngoscopy requires an assessment of the adjunctive devices used to facilitate intubation. In this study, subjects performed malleable bougie-assisted intubation and curved forceps removal of a glottic foreign body using videolaryngoscopy on a lightly embalmed cadaver and completed a post-procedure questionnaire. All subjects valued access to the malleable bougie available at their hospitals and 82% valued access to the curved forceps. Malleable bougie and curved forceps seem well-suited to facilitate videolaryngoscopic airway management.

The combined use of Skype and the STORZ CMAC video laryngoscope in field intubation training with the Nebraska National Air Guard.

This study examined the feasibility of using Skype technology in basic manikin intubation instruction of Nebraska National Air Guard personnel at a Casualty Training Exercise. Results show that the Skype monitor provided clear sound and visualization of the airway view to the trainees and the combination of VoIP technology and videolaryngoscopy for intubation training was highly valued by study participants.

Field use of the STORZ C-MAC video laryngoscope in intubation training with the Nebraska National Air Guard.

Previous studies have shown that the videolaryngoscope is an excellent intubation training tool as it allows the student and trainer to share the same anatomical view of the airway. Use of this training tool is limited; however, as many times intubation training must take place outside the hospital environment (as in the training of military health care providers). In this environment, the device can prove to be large and cumbersome. This study examined the use of the Storz CMAC, a compact video laryngoscope system, for intubation training in a simulated field hospital setting with the Nebraska National Air Guard. The study showed that the C-MAC was well-received by the trainees and would be useful in a deployment or hospital setting.