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BACKGROUND
At our institution, respiratory therapists may be certified to perform endotracheal intubation in
the adult population. Annual intubation certification includes both performing a certain number
of successful endotracheal intubations as well as a passing a skills and knowledge test. Our
practice has transitioned in the past few years from primarily using direct laryngoscopy to using
video laryngoscopy. In the past, direct laryngoscopy was the main method available. Recently, our
system placed a video laryngoscopy platform in all adult ICUs and Emergency Departments.
Impact of Laryngoscopy Type on Intubation Success Rate
John Emberger, Tom Gillin
ChristianaCare, Newark, DE
METHODS
A retrospective review of intubation documentation by respiratory therapists was conducted for
two different periods, January 2015 to December 2016 (direct - primary laryngoscopy type) and
July 2017 to May 2019 (video - primary laryngoscopy type). Successful tracheal intubation versus
unsuccessful tracheal intubation attempt were noted for each occurrence of intubation by a
respiratory therapist. Data was also collected specifically for video versus direct laryngoscopy
from January 2019 to May 2019, when video vs direct was added to the electric medical record as
a discreet data element.
HYPOTHESIS
We wanted to determine if respiratory therapists at our facility were more successful with
endotracheal intubation when using video laryngoscopy.
CONCLUSIONS
The success rate of a respiratory therapists certified in endotracheal intubation increased 8%
when video laryngoscopy became readily available in our system. With both types currently
available, respiratory therapists opt to use video laryngoscopy three times more frequently.
RESULTS
See data table below for success rate during the time when direct (Jan 15-Dec 16) and video (Jul
17-May 19) were the primary type of laryngoscopy. Success rate increased 8% from 86% to 94%
when video laryngoscopy became the primary type. The table also includes discreet data from
January 2019 to May 2019 comparing video versus direct success rate. Video is currently used 3
times more frequently than direct (100 vs 32) and has a success rate 8% higher than direct.
PRIMARY LARYNGOSCOPY TYPE BY PERIOD n Success Rate, %
DIRECT - Primary Type (Jan15-Dec16) 554 86%
VIDEO - Primary Type (Jul17-May19) 485 94% *
COMPARISON OF VIDEO AND DIRECT (Jan19-May19) n Success Rate, %
Video Laryngoscopy 100 96%
Direct Laryngoscopy 32 88% **
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