Direct Laryngoscopy (No airway reflexes)
| Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
|
I
|
Supportive (Green)
|
Modified Rankin Score at discharge
|
Patient
|
PH-Paramedic
|
Benger J., Kirby K., Black S., et al. Effect of a Strategy of a Supraglottic Airway Device vs Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome The AIRWAYS-2 Randomized Clinical Trial. JAMA 2018; 320(8):779-791 Medline
|
|
I
|
Supportive (Green)
|
modified Rankin Scale (mRS) score at 30 days/hospital discharge
|
Patient
|
PH-Paramedic
|
Benger JR, Lazaroo MJ, Clout M, Voss S, Black S, Brett SJ, et al. Randomized trial of the i-gel supraglottic airway device versus tracheal intubation during out of hospital cardiac arrest (AIRWAYS-2): Patient outcomes at three and six months. Resuscitation 2020; 157:74-82. Medline
|
|
I
|
Supportive (Green)
|
Survival
|
Patient
|
PH-Paramedic
|
Carney N, Totten AM, Cheney T, Jungbauer R, Neth MR, Weeks C, et al. Prehospital Airway Management: A Systematic Review. Prehosp Emerg Care 2021; 1–28. Medline
|
|
I
|
Supportive (Green)
|
Overall intubation success
|
Process
|
ED-MD
|
Goksu E., Kilic T., Yildiz G., Unal A., Kartal M. Comparison of the C-MAC video laryngoscope to the Macintosh laryngoscope for intubation of blunt trauma patients in the ED. Turkish journal of emergency medicine 2016; 16(2):53-56. Medline
|
|
I
|
Supportive (Green)
|
Favorable neurological outcome at 28 days
|
Patient
|
PH-MD & CCT
|
Jabre P., Penaloza A., Pinero D. Effect of Bag-Mask Ventilation vs Endotracheal Intubation During Cardiopulmonary Resuscitation on Neurological Outcome After Out-of-Hospital Cardiorespiratory Arrest: A Randomized Clinical Trial. JAMA. 2018; 319(8):779-787 Medline
|
|
I
|
Supportive (Green)
|
Sustained ROSC 2 or more hours after the CA.
|
Patient
|
PH-Paramedic
|
Lee AF, Chien YC, Lee BC, Yang WS, Wang YC, Lin HY, Huang EP, Chong KM, Sun JT, Huei-Ming M, Hsieh MJ, Chiang WC. Effect of Placement of a Supraglottic Airway Device vs Endotracheal Intubation on Return of Spontaneous Circulation in Adults With Out-of-Hospital Cardiac Arrest in Taipei, Taiwan: A Cluster Randomized Clinical Trial. JAMA Netw Open. 2022; 5(2):e2148871. Medline
|
|
I
|
Supportive (Green)
|
Failure of attempted airway
|
Process
|
ED-MD
|
Lewis SR., Butler AR., Parker J., Cook TM., Smith AF. Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation. The Cochrane database of systematic reviews 2016; 11:CD011136. Medline
|
|
I
|
Supportive (Green)
|
Success rate
|
Process
|
PH-MD & CCT
|
Trimmel H., Kreutziger J., Fertsak G., Fitzka R., Dittrich M., Voelckel WG. Use of the Airtraq laryngoscope for emergency intubation in the prehospital setting: a randomized control trial. Crit Care Med 2011; 39(3):489-493. Medline
|
|
I
|
Supportive (Green)
|
Success
|
Process
|
PH-MD & CCT
|
Trimmel H., Kreutziger J., Fitzka R., Szüts S., Derdak C., Koch E., et al. Use of the GlideScope Ranger Video Laryngoscope for Emergency Intubation in the Prehospital Setting: A Randomized Control Trial. Crit Care Med 2016; 44(7):e470-6. Medline
|
|
I
|
Neutral (Yellow)
|
Modified Rankin Score at discharge or 30 days
|
Patient
|
PH-Paramedic
|
Benger J., Kirby K., Black S., et al. Effect of a Strategy of a Supraglottic Airway Device vs Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome The AIRWAYS-2 Randomized Clinical Trial. JAMA 2018; 320(8):779-791 Medline
|
|
I
|
Neutral (Yellow)
|
First attempt success
|
Process
|
ED-MD
|
Bhattacharjee S., Maitra S., Baidya DK. A comparison between video laryngoscopy and direct laryngoscopy for endotracheal intubation in the emergency department: A meta-analysis of randomized controlled trials. J Clin Anesth 2018; 47:21-6. Medline
|
|
I
|
Neutral (Yellow)
|
First-pass success
|
Process
|
Other
|
Chien YT, Ong JR, Tam KW, Loh EW. Video laryngoscopy and direct laryngoscopy for cardiac arrest: A meta-analysis of clinical studies and trials. Am J Emerg Med August 2023; 73:116-124. Medline
|
|
I
|
Neutral (Yellow)
|
First pass success
|
Process
|
ED-MD
|
Driver BE., Prekker ME., Moore JC., Schick AL., Reardon RF., Miner JR. Direct Versus Video Laryngoscopy Using the C-MAC for Tracheal Intubation in the Emergency Department, a Randomized Controlled Trial. Academic emergency medicine 2016; 23(4):433-9 Medline
|
|
I
|
Neutral (Yellow)
|
Mortality
|
Patient
|
PH-Paramedic
|
Forestell B, Ramsden S, Sharif S, et al. Supraglottic Airway Versus Tracheal Intubation for Airway Management in Out-of-Hospital Cardiac Arrest: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis of Randomized Controlled Trials. Crit Care Med Nov 2023. Medline
|
|
I
|
Neutral (Yellow)
|
Success of airway management
|
Patient
|
PH-Paramedic
|
Jensen JL., Cheung KW., Tallon JM., Travers AH. Comparison of tracheal intubation and alternative airway techniques performed in the prehospital setting by paramedics: A systematic review. CJEM 2010; 12(2):135-40. Medline
|
|
I
|
Neutral (Yellow)
|
First pass success
|
Process
|
PH-Paramedic
|
Kent ME, Sciavolino BM, Blickley ZJ, Pasichow SH. Video laryngoscopy versus direct laryngoscopy for orotracheal intubation in the out-of-hospital environment: a systematic review and meta-analysis. Prehosp Emerg Care 2023; 1-16. Medline
|
|
I
|
Neutral (Yellow)
|
Survival
|
Patient
|
PH-Paramedic
|
Lecky F., Bryden D., Little R., Tong N., Moulton C. Emergency Intubation for acutely ill or injured patients. Cochrane Database of Systematic Reviews 2008; 2. Cochrane Library
|
|
I
|
Neutral (Yellow)
|
72 hour survival
|
Patient
|
PH-Paramedic
|
Lesnick JA, Moore JX, Zhang Y, Jarvis J, Nichol G, Daya MR, et al. Airway insertion first pass success and patient outcomes in adult out-of-hospital cardiac arrest: The Pragmatic Airway Resuscitation Trial. Resuscitation 2021; 158:151-6. Medline
|
|
I
|
Neutral (Yellow)
|
Survival to Hospital Discharge
|
Patient
|
PH-Paramedic
|
Lou J, Tian S, Kang X, et al. Airway management in out-of-hospital cardiac arrest: A systematic review and network meta-analysis. Am J Emerg Med Dec 2022; 65:130-8. Medline
|
|
I
|
Neutral (Yellow)
|
Survival to hospital discharge
|
Process
|
PH-Paramedic & MD
|
Wang CH, Lee AF, Chang WT, et al. Comparing Effectiveness of Initial Airway Interventions for Out-of-Hospital Cardiac Arrest: A Systematic Review and Network Meta-analysis of Clinical Controlled Trials [published online ahead of print, 2020 Jan 23]. Ann Emerg Med. 2020;S0196-0644(19)31434-9. doi:10.1016/j.annemergmed.2019.12.003 Medline
|
|
I
|
Opposes (Red)
|
72-hour survival
|
Patient
|
PH-Paramedic
|
Wang H., Schmicker R., Daya M. Effect of a Strategy of Initial Laryngeal Tube Insertion vs Endotracheal Intubation on 72-Hour Survival in Adults With Out-of-Hospital Cardiac Arrest A Randomized Clinical Trial. JAMA 2018; 320(8):769-778. Medline
|
|
II
|
Supportive (Green)
|
EtCO2 during CPR
|
Process
|
|
Becker TK, Berning AW, Prabhu A, Callaway CW, Guyette FX, Martin-Gill C. An assessment of ventilation and perfusion markers in out-of-hospital cardiac arrest patients receiving mechanical CPR with endotracheal or supraglottic airways. Resuscitation 2018; 122:61-4. Medline
|
|
II
|
Supportive (Green)
|
ROSC, Survival to Discharge, Neuro intact Survival
|
Patient
|
PH-Paramedic
|
Benoit JL., Gerecht RB., Steuerwald MT., McMullan JT. Endotracheal intubation versus supraglottic airway placement in out-of-hospital cardiac arrest: A meta-analysis. Resuscitation 2015; 93:20-6. Medline
|
|
II
|
Supportive (Green)
|
Survival to discharge
|
Patient
|
|
Chiang W., Hsieh M., Chu H., et al. The Effect of Successful Intubation on Patient Outcomes After Out-of-Hospital Cardiac Arrest in Taipei. Ann Emerg Med 2018; 71(3):387-96. Medline
|
|
II
|
Supportive (Green)
|
Intubation success, Oxygen saturation
|
Process
|
PH-Paramedic
|
Davis DP., et al. Predictors of intubation success and therapeutic value of paramedic airway management in a large, urban EMS system. Prehosp Emerg Care 2006; 10:356-62. Medline
|
|
II
|
Supportive (Green)
|
Successful tube placement
|
Process
|
|
Dyson K., Bray JE., Smith K., Bernard S., Straney L., Nair R., et al. Paramedic Intubation Experience Is Associated With Successful Tube Placement but Not Cardiac Arrest Survival. Ann Emerg Med 2017; 70(3):382-390 Medline
|
|
II
|
Supportive (Green)
|
Favorable neurologic outcome one month post event.
|
Patient
|
PH-Paramedic
|
Fukuda T, Ohashi-Fukuda N, Inokuchi R, Kondo Y, Sekiguchi H, Taira T, et al. Association between time to advanced airway management and neurologically favourable survival during out-of-hospital cardiac arrest. Anaesth Crit Care Pain 2021; 100906. Medline
|
|
II
|
Supportive (Green)
|
Success rate
|
Patient
|
Other
|
Hansel J, Rogers AM, Lewis SR, Cook TM, Smith AF. Videolaryngoscopy versus direct laryngoscopy for adults undergoing tracheal intubation. Cochrane Database Syst Rev 2022; 4(4):CD011136. Medline
|
|
II
|
Supportive (Green)
|
Success rate
|
Process
|
|
Hiltunen P., Jäntti H., Silfvast T., Kuisma M., Kurola J. Airway management in out-of-hospital cardiac arrest in Finland: current practices and outcomes. Scandinavian journal of trauma, resuscitation and emergency medicine 2016;24:49. Medline
|
|
II
|
Supportive (Green)
|
Functionally favourable survival at one-month
|
Patient
|
PH-Paramedic
|
Izawa J., Iwami T., Gibo K., Okubo M., Kajino K., Kiyohara K., et al. Timing of advanced airway management by emergency medical services personnel following out-of-hospital cardiac arrest A population-based cohort study. Resuscitation 2018; 128 16-23. Medline
|
|
II
|
Supportive (Green)
|
Survival at one month or at hospital discharge within
one month
|
Patient
|
PH-Paramedic
|
Izawa J., Komukai S., Gibo K., Okubo M., Kiyohara K., Nishiyama C., et al. Pre-hospital advanced airway management for adults with out-of-hospital cardiac arrest: nationwide cohort study. BMJ (Clinical research ed) 2019; 364:l430. Medline
|
|
II
|
Supportive (Green)
|
Multiple measures of chest compression interruptions
|
Process
|
|
Jarman AF., Hopkins CL., Hansen JN., Brown JR., Burk C., Youngquist ST. Advanced Airway Type and Its Association with Chest Compression Interruptions During Out-of-Hospital Cardiac Arrest Resuscitation Attempts. Prehosp Emerg Care 2017; 21(5):628-35. Medline
|
|
II
|
Supportive (Green)
|
Time to successful ETI
|
Patient
|
PH-Paramedic & CCT
|
Kluj P, Fedorczak M, Gaszyński T, Ratajczyk P. A pilot, prospective trial of IntuBrite® versus Macintosh direct laryngoscopy for paramedic endotracheal intubation in out of hospital cardiac arrest. BMC Emerg Med 2023; 23(1):70. Medline
|
|
II
|
Supportive (Green)
|
First pass success
|
Process
|
|
Lee JK., Kang H., Choi HJ. Changes in the first-pass success rate with the GlideScope video laryngoscope and direct laryngoscope: a ten-year observational study in two academic emergency departments. Clinical and Experimental Emergency Medicine 2016; 3(4):213-218. Medline
|
|
II
|
Supportive (Green)
|
Intubation success rate
|
Process
|
PH-Paramedic
|
Lossius HM., Roislien J., Lockey DJ. Patient safety in pre-hospital emergency tracheal intubation: A comprehensive meta-analysis of the intubation success rates of EMS providers. Crit Care 2012; 16(1):R24. Medline
|
|
II
|
Supportive (Green)
|
ROSC
|
Patient
|
PH-Paramedic & MD
|
Montag S, Herdtle S, John S, Lehmann T, Behringer W, Hohenstein C. Association between prehospital FPS and ROSC in adults with OHCA: A retrospective multicenter study using the German Resuscitation Registry and Intubation Registry (FiPS-CPR). Anaesthesiologie 2022. Medline
|
|
II
|
Supportive (Green)
|
Neurologically favorable one-month survival, defined as CPC category 1 or 2, following advanced airway management by emergency life support technicians during out-of-hospital cardiac arrest.
|
Patient
|
PH-Paramedic
|
Onoe A, Kajino K, MR D, Nakamura F, Nakajima M, Kishimoto M, et al. Improved neurologically favorable survival after OHCA is associated with increased pre-hospital advanced airway management at the prefecture level in Japan. Sci Rep Nov 2022; 12(1):20498. Medline
|
|
II
|
Supportive (Green)
|
Survival to hospital admission
|
Patient
|
PH-Paramedic
|
Ryan KM, Bui MD, Dugas JN, Zvonar I, Tobin JM. Impact of prehospital airway interventions on outcome in cardiac arrest following drowning: A study from the CARES Surveillance Group. Resuscitation 2021; 163:130–5. Medline
|
|
II
|
Supportive (Green)
|
First pass success
|
Process
|
|
Sakles JC., Mosier JM., Patanwala AE., Arcaris B., Dicken JM. The Utility of the C-MAC as a Direct Laryngoscope for Intubation in the Emergency Department. J Emerg Med 2016; 51(4):349-57. Medline
|
|
II
|
Supportive (Green)
|
Efficacy of oxygenation technique in OHCA
|
Process
|
ED-Paramedic & MD
|
Song SR, Kim KH, Park JH, Song KJ, Shin SD. Association between prehospital airway type and oxygenation and ventilation in out-of-hospital cardiac arrest. Am J Emerg Med March 2023; 65:24-30. Medline
|
|
II
|
Supportive (Green)
|
30-day survival
|
Patient
|
|
Sulzgruber P., Datler P., Sterz F., Poppe M., Lobmeyr E., Keferböck M., et al. The impact of airway strategy on the patient outcome after out-of-hospital cardiac arrest: A propensity score matched analysis. Eur Heart J Acute Cardiovasc Care 2018; 7(5):423-431. Medline
|
|
II
|
Supportive (Green)
|
Neurologically favorable 1-month survival
|
Patient
|
PH-Paramedic
|
Tanabe S., Ogawa T., Akahane M., et al. Comparison of neurological outcome between tracheal intubation and supraglottic airway device insertion of out-of-hospital cardiac arrest patients: A nationwide, population-based, observational study. J Emerg Med 2013; 44(2):389-397. Medline
|
|
II
|
Supportive (Green)
|
Survival to discharge
|
Patient
|
PH-Paramedic
|
Wang H., Szydlo D., Stouffer J., Lin S., Carlson J., Vaillancourt C., Sears G., Verbeek R., Fowler R., Idris R., Koenig K., Christenson J., Minokadeh A., Brandt J., Rea T. Endotracheal intubation versus supraglottic airway insertion in out-of-hospital cardiac arrest. Resuscitation 2012; 83:1061-1066. Medline
|
|
II
|
Supportive (Green)
|
Successful ventilation
|
Patient
|
OR
|
Winchell RJ., Hoyt DB. Endotracheal intubation in the field improves survival in patients with severe head injury. Arch Surg 1997; 132:592-597. Medline
|
|
II
|
Neutral (Yellow)
|
First pass success
|
Patient
|
Other
|
Arulkumaran N., Lowe J., Ions R., Mendoza M., Bennett V., Dunser MW. Videolaryngoscopy versus direct laryngoscopy for emergency orotracheal intubation outside the operating room: a systematic review and meta-analysis. Br J Anaesth 2018; 120(4):712-24. Medline
|
|
II
|
Neutral (Yellow)
|
Successful placement
|
Process
|
PH-Paramedic
|
Brown LH., Hubble MW., Wilfong DA., Hertelendy A., Benner RW. Airway management in the air medical setting. Air Med J 2011; 30(3):140-8. Medline
|
|
II
|
Neutral (Yellow)
|
Intubation success rate
|
Process
|
|
Crewdson K., Lockey DJ., Røislien J., Lossius HM., Rehn M. The success of pre-hospital tracheal intubation by different pre-hospital providers: a systematic literature review and meta-analysis. Crit Care 2017; 21(1):31. Medline
|
|
II
|
Neutral (Yellow)
|
Neurological outcome (CPC)
|
Patient
|
PH-Paramedic
|
Edwards T., Williams J., Cottee M. Influence of prehospital airway management on neurological outcome in patients transferred to a heart attack centre following out-of-hospital cardiac arrest. EMA 2019; 31(1):76-82. Medline
|
|
II
|
Neutral (Yellow)
|
Intubation success rate
|
Process
|
PH-Paramedic
|
Garza AG., Gratton MC., Coontz D., Noble E., Ma OJ. Effect of paramedic experience on orotracheal intubation success rates. J Emerg Med 2003; 25:251-6. Medline
|
|
II
|
Neutral (Yellow)
|
Survival
|
Patient
|
Other
|
Granfeldt A., Avis SR., Nicholson TC., Holmberg MJ., Moskowitz A., Coker A., et al. Advanced airway management during adult cardiac arrest: A systematic review. Resuscitation 2019; 139:133-43. Medline
|
|
II
|
Neutral (Yellow)
|
Success rate
|
Patient
|
PH-Paramedic
|
Hubble MW., Brown L., Wilfong DA., Hertelendy A., Benner RW., Richards ME. A meta-analysis of prehospital airway control techniques part I: Orotracheal and nasotracheal intubation success rates. Prehosp Emerg Care 2010; 14(3):377-401. Medline
|
|
II
|
Neutral (Yellow)
|
First pass success.
|
Process
|
PH-Paramedic
|
Jarman AF., Hopkins CL., Hansen JN., Brown JR., Burk C., Youngquist ST. Advanced Airway Type and Its Association with Chest Compression Interruptions During Out-of-Hospital Cardiac Arrest Resuscitation Attempts. Prehosp Emerg Care 2017; 21(5):628-35. Medline
|
|
II
|
Neutral (Yellow)
|
One month survival with favorable neurological outcome
|
Patient
|
PH-Paramedic
|
Kajino K., Iwami T., Kitamura T., et al. Comparison of supraglottic airway versus endotracheal intubation for the pre-hospital treatment of out-of-hospital cardiac arrest. Crit Care 2011; 15(5):R236. Medline
|
|
II
|
Neutral (Yellow)
|
Sustained ROSC
|
Patient
|
PH-Paramedic
|
McMullan J., Gerecht R., Bonomo .J, Robb R., McNally B., Donnelly J., Wang H. Airway management and out-of-hospital cardiac arrest outcome in the CARES registry. Resuscitation 2014; 85(5):617–22. Medline
|
|
II
|
Neutral (Yellow)
|
Intubation success rate
|
Process
|
|
Myers LA., Gallet CG., Kolb LJ., Lohse CM., Russi CS. Determinants of Success and Failure in Prehospital Endotracheal Intubation. The Western Journal of Emergency Medicine 2016; 17(5):640-7. Medline
|
|
II
|
Neutral (Yellow)
|
Cerebral Performance Category at one month
|
Patient
|
PH-Paramedic
|
Nakagawa K, Sagisaka R, Tanaka S, Takyu H, Tanaka H. Early endotracheal intubation improves neurological outcome following witnessed out-of-hospital cardiac arrest in Japan: a population-based observational study. Acute Med Surg 2021; 8(1):e650. Medline
|
|
II
|
Neutral (Yellow)
|
PaCO2 and PaO2 levels
|
Patient
|
PH-Paramedic
|
Nakayama R, Bunya N, Uemura S, Sawamoto K, Narimatsu E. Prehospital advanced airway management and ventilation for out-of-hospital cardiac arrest with prehospital return of spontaneous circulation: a prospective observational cohort study in Japan. Prehosp Emerg Care Sept 2023; 1-12. Medline
|
|
II
|
Neutral (Yellow)
|
favourable neurological outcome at 1 month
|
Patient
|
PH-Paramedic & MD
|
Otomune K, Hifumi T, Jinno K, Nakamura K, Okazaki T, Inoue A, Kawakita K, Kuroda Y. Neurological outcomes associated with prehospital advanced airway management in patients with out-of-hospital cardiac arrest due to foreign body airway obstruction. Resusc Plus 2021; 7():100140. Medline
|
|
II
|
Neutral (Yellow)
|
ROSC post-resuscitative thoracostomy
|
Patient
|
Other
|
Radulovic N, Hillier M, Nisenbaum R, Turner L, Nolan B. The impact of out-of-hospital time and prehospital intubation on return of spontaneous circulation following resuscitative thoracotomy in traumatic cardiac arrest. Prehosp Emerg Care Nov 2023; 1-14. Medline
|
|
II
|
Neutral (Yellow)
|
First-pass intubation success
|
Process
|
|
Savino PB., Reichelderfer S., Mercer MP., Wang RC., Sporer KA. Direct Versus Video Laryngoscopy for Prehospital Intubation: A Systematic Review and Meta-analysis. Academic Emergency Medicine 2017; 24(8):1018-26. Medline
|
|
II
|
Neutral (Yellow)
|
Survival
|
Patient
|
PH-Paramedic
|
Stiell IG., et al. Advanced Cardiac Life Support in Out-of-Hospital Cardiac Arrest. NEJM 2004; 351:647-56. Medline
|
|
II
|
Neutral (Yellow)
|
Rate of healing
|
Process
|
ED-MD
|
Wang HE, Cook LJ, Change CCH, Yealy DM, Lave JR (2009). Outcomes after Out-of Hospital Endotracheal Intubation errors. Resus 80; 50-5. Medline
|
|
II
|
Neutral (Yellow)
|
Survival to discharge, 24-hour survival
|
Patient
|
In-Patient
|
Wong ML., Carey S., Mader T., Wang HE., et al. Time to invasive airway placement and resuscitation outcomes after in-hospital cardiopulmonary arrest. Resusc 2010; 81(2):182-6. Medline
|
|
II
|
Neutral (Yellow)
|
Success
|
Process
|
PH-Paramedic
|
Wylie CA, Araie F, Hendrikse C, Burke J, Joubert I, Hardy A, et al. A retrospective descriptive analysis of non-physician-performed prehospital endotracheal intubation practices and performance in South Africa. BMC Emerg Med 2022; 22(1):129. Medline
|
|
II
|
Opposes (Red)
|
Appropriate treatment
|
Patient
|
PH-Paramedic
|
Bochicchio GV., Obeid I., Manjari J., Bochicchio K., Scalea T. Endotracheal Intubation in the Field Does Not Improve Outcome in Trauma Patients Who Present Without an Acutely Lethal Traumatic Brain Injury. J Trauma 2003; 54(2):307-11. Medline
|
|
II
|
Opposes (Red)
|
Long-term Survival
|
Patient
|
PH-Paramedic
|
Fouche PF., Simpson PM., Bendall J., Thomas RE., Cone DC., Doi SA. Airways in out-of-hospital cardiac arrest: Systematic review and meta-analysis. Prehosp Emerg Care 2014; 18(2):244-56. Medline
|
|
II
|
Opposes (Red)
|
Survival to hospital discharge.
|
Patient
|
PH-Paramedic & CCT
|
Fouche PF., Smith K., Jennings PA., Boyle M., Bernard S. The association of paramedic rapid sequence intubation and survival in out-of-hospital stroke. EMJ 2019; 36(7):416-22. Medline
|
|
II
|
Opposes (Red)
|
Favourable neurological outcome
|
Patient
|
PH-Paramedic
|
Fukuda T., Fukuda-Ohashi N., Doi K., Matsubara T., Yahagi N. Effective pre-hospital care for out-of-hospital cardiac arrest caused by respiratory disease. Heart Lung Circ 2015; 24(3):241-9. Medline
|
|
II
|
Opposes (Red)
|
Survival to discharge
|
Process
|
PH-Paramedic
|
Hanif MA., Kaji AH., Niemann JT. Advanced airway management does not improve outcome of out-of-hospital cardiac arrest. Acad Emerg Med 2010; 17(9):926-31. Medline
|
|
II
|
Opposes (Red)
|
Favourable neurological outcome 1 month
|
Patient
|
PH-Paramedic
|
Hasegawa K., Hiraide A., Chang Y., Brown DF. Association of prehospital advanced airway management with neurologic outcome and survival in patients with out-of-hospital cardiac arrest. JAMA 2013; 309(3):257-66. Medline
|
|
II
|
Opposes (Red)
|
Survival to discharge
|
Patient
|
|
Jeong S., Ahn KO., Shin SD. The role of prehospital advanced airway management on outcomes for out-of-hospital cardiac arrest patients: a meta-analysis. Am J Emerg Med 2016; 34(11):2101-2106. Medline
|
|
II
|
Opposes (Red)
|
Neurologically favourable survival at one month
|
Patient
|
|
Ohashi-Fukuda N., Fukuda T., Yahagi N. Effect of pre-hospital advanced airway management for out-of-hospital cardiac arrest caused by respiratory disease: a propensity score-matched study. Anaesth Intensive Care 2017; 45(3):375-83. Medline
|
|
II
|
Opposes (Red)
|
Symptom recovery
|
Patient
|
ED-MD
|
Shafi S., Gentilello L. Prehospital endotracheal intubation and positive pressure ventilation in association with hypotension and decreased survival in hypovolemic trauma patients: an analysis of the national trauma data bank. J Trauma 2005; (59)5:1140. Medline
|
|
II
|
Opposes (Red)
|
Survival
|
Patient
|
PH-Paramedic
|
Wirtz DD., Ortiz C., Newman DH., Zhitomirsky I. Unrecognized misplacement of endotracheal tubes by ground prehospital providers. Prehosp Emerg Care 2007; 11:213-8. Medline
|
|
II
|
Opposes (Red)
|
Survival
|
Patient
|
PH-Paramedic
|
Wirtz DD., Ortiz C., Newman DH., Zhitomirsky I. Unrecognized misplacement of endotracheal tubes by ground prehospital providers. Prehosp Emerg Care 2007; 11:213-8. Medline
|
|
III
|
Supportive (Green)
|
Rate of success, time to success
|
Process
|
SIM
|
Bollig G., Lovhaug SW., Sagen O., Svendsen MV., Steen PA., Wik L. Airway management by paramedics using endotracheal intubation with a laryngoscope versus the oesophageal tracheal Combitube and EasyTube on manikins: a randomised experimental trial. Resuscitation 2006; 71(1):107-11. Medline
|
|
III
|
Supportive (Green)
|
Time to insertion, attempts
|
Process
|
SIM
|
Calkins MD., Robinson TD. Combat trauma airway management: endotracheal intubation versus laryngeal mask airway versus combitube use by Navy SEAL and Reconnaissance combat corpsmen. J Trauma 1999; 46(5):927-32. Medline
|
|
III
|
Supportive (Green)
|
First Pass Success
|
Process
|
|
Ducharme S., Kramer B., Gelbart D., Colleran C., Risavi B., Carlson JN. A pilot, prospective, randomized trial of video versus direct laryngoscopy for paramedic endotracheal intubation. Resuscitation 2017; 114:121-126. Medline
|
|
III
|
Supportive (Green)
|
Time to intubation
|
Process
|
|
Gawlowski P., Smereka J., Madziala M., Cohen B., Ruetzler K., Szarpak L. Comparison of the ETView Single Lumen and Macintosh laryngoscopes for endotracheal intubation in an airway manikin with immobilized cervical spine by novice paramedics: A randomized crossover manikin trial. Medicine 2017; 96(16):e5873. Medline
|
|
III
|
Supportive (Green)
|
Success rates
|
Process
|
PH-Paramedic
|
Jacobs LM., Berrizbeitia LD., Bennett B., et al. Endotracheal intubation in the prehospital phase of emergency medical care. JAMA 1983; 250:2175-7. Medline
|
|
III
|
Supportive (Green)
|
Intubation success
|
Process
|
SIM
|
Komasawa N., Atagi K., Ueki R., Nishi S., Kaminoh Y., Tashiro C. Comparison of optic laryngoscope Airtraq((R)) and Miller laryngoscope for tracheal intubation during infant cardiopulmonary resuscitation. Resuscitation 2011; 82(6):736-9. Medline
|
|
III
|
Supportive (Green)
|
Intubation success
|
Process
|
SIM
|
Nasim S., Maharaj CH., Malik MA., O'Donnell J., Higgins BD., Laffey JG. Comparison of the glidescope and pentax AWS laryngoscopes to the macintosh laryngoscope for use by advanced paramedics in easy and simulated difficult intubation. BMC Emerg Med 2009; 9:9-227X. Medline
|
|
III
|
Supportive (Green)
|
Success rate
|
Process
|
PH-Paramedic
|
Pratt JC. Endotracheal Tube Placement by EMT-B in a Rural System. Prehospital Emerg Care 2005; 9(2):172-5. Medline
|
|
III
|
Supportive (Green)
|
Success
|
Patient
|
|
Swanson ER., Fosnocht DE., Matthews K., Barton ED. Comparison of the intubating laryngeal mask airway versus laryngoscopy in the bell 206-L3 EMS helicopter. Air Med J 2004; 23(1):36-39. Medline
|
|
III
|
Supportive (Green)
|
Endotracheal intubation (ETI) attempts, success rates
|
Patient
|
|
Thomas S., Judge T., Lowell MJ., et al. Airway management success and hypoxemia rates in air and ground critical care transport: A prospective multicenter study. Prehosp Emerg Care 2010; 14(3):283. Medline
|
|
III
|
Supportive (Green)
|
Time to ventilate after successful intubation
|
Process
|
SIM
|
Ueshima H., Asai T. Tracheal intubation in daylight and in the dark: a randomised comparison of the Airway Scope, Airtraq, and Macintosh laryngoscope in a manikin. Anaesthesia 2010; 65(7):684-687. Medline
|
|
III
|
Supportive (Green)
|
Success
|
Patient
|
PH-Paramedic
|
Wang HE., Kupas DF., Paris PM., Bates RR., Yealy DM. Preliminary experience with a prospective, multi-centered evaluation of out-of-hospital endotracheal intubation. Resus 2003; 58:49-58. Medline
|
|
III
|
Supportive (Green)
|
Success rate
|
Process
|
|
Yildirim A., Kiraz HA., Ağaoğlu, Akdur O. Comparison of Macintosh, McCoy and C-MAC D-Blade video laryngoscope intubation by prehospital emergency health workers: a simulation study. Intern Emerg Med 2017; 12(1):91-97. Medline
|
|
III
|
Supportive (Green)
|
Time to intubation
|
Process
|
|
Yousif S., Machan JT., Alaska Y., Suner S. Airway Management in Disaster Response: A Manikin Study Comparing Direct and Video Laryngoscopy for Endotracheal Intubation by Prehospital Providers in Level C Personal Protective Equipment. Prehosp Disaster Med 2017; 32(4):352-356. Medline
|
|
III
|
Neutral (Yellow)
|
Description of clinical characteristics
|
Patient
|
|
Adnet F., Jouriles JN., Toumelin PL. Survey of out-of-hospital emergency intubations in the French prehospital medical system: A multicenter study. Ann Emerg Med 1998; 32:454-60. Medline
|
|
III
|
Neutral (Yellow)
|
Success rate, annual number of ETI per provider
|
Process
|
PH-Paramedic
|
Burton JH., Baumann MR., Maoz T., Bradshaw JR., Lebrun JE. Endotracheal intubation in a rural EMS state: procedure utilization and impact of skills maintenance guidelines. Prehosp Emerg Care 2003; 7:352-6. Medline
|
|
III
|
Neutral (Yellow)
|
Successful intubation
|
Process
|
SIM
|
Cinar O., Cevik E., Yildirim AO., Yasar M., Kilic E., Comert B. Comparison of GlideScope video laryngoscope and intubating laryngeal mask airway with direct laryngoscopy for endotracheal intubation. Eur J Emerg Med 2011; 18(2):117-20. Medline
|
|
III
|
Neutral (Yellow)
|
Success
|
Process
|
ED-MD
|
Denver Metro Airway Study Group. A Prospective Multicentre Evaluation of Prehospital Airway Management in a Large Metropolitan Region. Prehospital Emergency Care 2009; 13(3):304-10. Medline
|
|
III
|
Neutral (Yellow)
|
First pass success rate
|
Process
|
|
Hafner JW., Perkins BW., Korosac JD., Bucher AK., Aldag JC., Cox KL. Intubation Performance of Advanced Airway Devices in a Helicopter Emergency Medical Service Setting. Air Med J 2016; 35(3):132-7. Medline
|
|
III
|
Neutral (Yellow)
|
First Pass Success
|
Patient
|
ED-MD
|
Hale JJ., Lynch S., Ray DC., Reid LA., . Adolescent tracheal intubation in an adult urban emergency department a retrospective, observational study. European journal of emergency medicine 2017; 24(6) e6-10. Medline
|
|
III
|
Neutral (Yellow)
|
Time to first ventilation
|
Process
|
Other
|
Hansen ML, Wagner A, Schnapp A, Lin A, Le N, Deverman S, et al. Cluster cross-over randomised trial of paediatric airway management devices in the simulation lab and operating room among paramedic students. Emerg Med J 2021; 38(1):27-32. Medline
|
|
III
|
Neutral (Yellow)
|
Success rate of endotracheal intubation
|
Process
|
|
Kim JW., Park SO., Lee KR., Hong DY., Baek KJ., Lee YH., et al. Video laryngoscopy vs. direct laryngoscopy: Which should be chosen for endotracheal intubation during cardiopulmonary resuscitation? A prospective randomized controlled study of experienced intubators. Resuscitation 2016; 105:196-202. Medline
|
|
III
|
Neutral (Yellow)
|
Time to Intubation
|
Process
|
SIM
|
Kim YM., Kang HG., Kim JH., Chung HS., Yim HW., Jeong SH. Direct versus video laryngoscopic intubation by novice prehospital intubators with and without chest compressions: A pilot manikin study. Prehosp Emerg Care 2011; 15(1):98-103. Medline
|
|
III
|
Neutral (Yellow)
|
Success
|
Process
|
PH-Paramedic
|
Kurola J., et al. Airway management in cardiac arrest - comparison of LT, TI, BMV in emergency medical training. Resus 2005; 61:149-53. Medline
|
|
III
|
Neutral (Yellow)
|
First pass success
|
Patient
|
PH-Paramedic & CCT
|
Lenz T, Olsen J. Direct Versus Video Laryngoscopy in a Helicopter Emergency Medical Services Setting: A Retrospective Comparison. Air Med J 2021; 40(6):427–30. Medline
|
|
III
|
Neutral (Yellow)
|
Intubation success
|
Process
|
SIM
|
Lewis AR., Hodzovic I., Whelan J., Wilkes AR., Bowler I., Whitfield R. A paramedic study comparing the use of the Airtraq, Airway Scope and Macintosh laryngoscopes in simulated prehospital airway scenarios. Anaesthesia 2010; 65(12):1187-93. Medline
|
|
III
|
Neutral (Yellow)
|
Resolution
|
Patient
|
ED-MD
|
Liu L., Tanigawa K., Kusunoki S., Tamura T., Ota K., Yamaga S., et al. Tracheal intubation of a difficult airway using Airway Scope, Airtraq, and Macintosh laryngoscope: A comparative manikin study of inexperienced personnel. Anesth Analg 2010; 110(4):1049-55. Medline
|
|
III
|
Neutral (Yellow)
|
Success rate
|
Process
|
SIM
|
Messa MJ., Kupas DF., Dunham DL. Comparison of bougie-assisted intubation with traditional endotracheal intubation in a simulated difficult airway. Prehosp Emerg Care 2011; 15(1):30-3. Medline
|
|
III
|
Neutral (Yellow)
|
Successful endotracheal intubation
|
Process
|
PH-Paramedic
|
Nichols M, Fouche PF, Bendall JC. Video versus direct laryngoscopy by specialist paramedics in New South Wales: Preliminary results from a new airway registry. Emerg Med Australas 2022. Medline
|
|
III
|
Neutral (Yellow)
|
Success rate
|
Process
|
|
Pieters BM., Wilbers NE., Huijzer M., Winkens B., van Zundert AA. Comparison of seven videolaryngoscopes with the Macintosh laryngoscope in manikins by experienced and novice personnel. Anaesthesia 2016; 71(5):556-64. Medline
|
|
III
|
Neutral (Yellow)
|
time to tracheal intubation
|
Process
|
SIM
|
Ratajczyk P, Dolder P, Szmyd B, et al. Comparison of UESCOPE VL 400, I-View, Non-Channeled Airtraq Videolaryngoscopes and Macintosh Laryngoscope for Tracheal Intubation in Simulated Out-of-Hospital Conditions: A Randomized Crossover Manikin Study. Healthc February 2024; 12(4). Medline
|
|
III
|
Neutral (Yellow)
|
Successful intubation rate
|
Process
|
SIM
|
Ratajczyk P, Fedorczak M, Kluj P, Gaszynski T. A comparison of tracheal intubation using intubrite laryngoscope and conventional MAC laryngoscope: An open, prospective, crossover manikin study. Med Nov 2023; 102(45):e35846. Medline
|
|
III
|
Neutral (Yellow)
|
Time to placement
|
Process
|
SIM
|
Southard A., Braude D., Crandall C. Rapid sequence airway vs rapid sequence intubation in a simulated trauma airway by flight crew. Resuscitation 2010; 81(5):576-578. Medline
|
|
III
|
Neutral (Yellow)
|
Time to intubation
|
Process
|
|
Truszewski Z., Czyzewski L., Smereka J., Krajewski P., Fudalej M., Madziala M., et al. Ability of paramedics to perform endotracheal intubation during continuous chest compressions: a randomized cadaver study comparing Pentax AWS and Macintosh laryngoscopes. Am J Emerg Med 2016; 34(9):1835-9. Medline
|
|
III
|
Neutral (Yellow)
|
Functional of-hospital airway management in the United States
|
Patient
|
PH-Paramedic
|
Wang HE., Mann NC., Mears G., Jacobson K., Yealy D. Out-of-hospital airway management in the United States. Resuscitation 2011; 82(4):378–385. Medline
|
|
III
|
Neutral (Yellow)
|
Number of attempts to intubate
|
Patient
|
PH-Paramedic
|
Wang HE., Yealy DM. How many attempts are required to accomplish out-of-hospital endotracheal intubation? Acad Emer Med 2006; 13(4):372-7. Medline
|
|
III
|
Neutral (Yellow)
|
Reduction in no flow time
|
Patient
|
SIM
|
Wiese CH., Bartels U., Bergmann A., Bergmann I., Bahr J., Graf BM. Using a laryngeal tube during cardiac arrest reduces "no flow time" in a manikin study: A comparison between laryngeal tube and endotracheal tube. Wien Klin Wochenschr 2008; 120(7-8):217-223. Medline
|
|
III
|
Neutral (Yellow)
|
intubation success
|
Process
|
SIM
|
Wik L., Naess AC., Steen PA. Intubation with laryngoscope versus transillumination performed by paramedic students on manikins and cadavers. Resuscitation 1997; 33(3):215-218. Medline
|
|
III
|
Neutral (Yellow)
|
First pass success
|
Process
|
ED-MD
|
Wollard M. et al. Airtraq vs. standard laryngoscopy by student paramedics and experienced prehospital laryngoscopists managing a model of difficult intubation. Anaesth 2008; 63:26-31. Medline
|
|
III
|
Neutral (Yellow)
|
Time to successful ventilation
|
Process
|
SIM
|
Yun BJ., Brown CA.,3rd, Grazioso CJ., Pozner CN., Raja AS. Comparison of video, optical, and direct laryngoscopy by experienced tactical paramedics. Prehosp Emerg Care 2014; 18(3):442-445. Medline
|
|
X
|
Not Yet Graded (White)
|
-
|
|
|
Kolaparambil Varghese LJ, Völlering JJ, De Robertis E, Hinkelbein J, Schmitz J, Warnecke T. Efficacy of endotracheal intubation in helicopter cabin vs. ground: a systematic review and meta-analysis. Scand J Trauma Resusc Emerg Med May 2024; 32(1):40. Medline
|
|
X
|
Not Yet Graded (White)
|
-
|
|
|
Li W, Ahghari M, von Vopelius-Feldt J, Nolan B. The Impact of Location and Asset Type on the Success of Advanced Airway Management in a Critical Care Transport Environment. Air Med J Sept 2024; 43(5):416-20. Medline
|
Direct Laryngoscopy (with airway reflexes)
| Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
|
I
|
Supportive (Green)
|
Success
|
Process
|
|
Trimmel H., Kreutziger J., Fitzka R., Szüts S., Derdak C., Koch E., et al. Use of the GlideScope Ranger Video Laryngoscope for Emergency Intubation in the Prehospital Setting: A Randomized Control Trial. Crit Care Med 2016; 44(7):e470-6. Medline
|
|
I
|
Neutral (Yellow)
|
Success
|
Process
|
OR
|
Avidan MS., Harvey A., Chitkara N., Ponte J. The intubating laryngeal mask airway compared with direct laryngoscopy. Br J Anaesth 1999; 83(4):615-7. Medline
|
|
I
|
Neutral (Yellow)
|
Ease and speed of placement
|
Process
|
OR
|
Brimacombe J. The advantages of the LMA over the tracheal tube or facemask: a meta-analysis. Can J Anaesth 1995; 42(11):1017-23. Medline
|
|
I
|
Neutral (Yellow)
|
intubation time
|
Process
|
OR
|
Chalkeidis O., Kotsovolis G., Kalakonas A., Filippidou M., Triantafyllou C., Vaikos D., et al. A comparison between the Airtraq and Macintosh laryngoscopes for routine airway management by experienced anesthesiologists: a randomized clinical trial. Acta Anaesthesiol Taiwan 2010; 48(1):15-20. Medline
|
|
I
|
Neutral (Yellow)
|
First pass success
|
Process
|
|
Driver BE., Prekker ME., Moore JC., Schick AL., Reardon RF., Miner JR. Direct Versus Video Laryngoscopy Using the C-MAC for Tracheal Intubation in the Emergency Department, a Randomized Controlled Trial. Academic emergency medicine 2016; 23(4):433-9 Medline
|
|
I
|
Neutral (Yellow)
|
intubation success after three attempts
|
Patient
|
OR
|
Hung OR., Pytka S., Morris I., Murphy M., Launcelott G., Stevens S., et al. Clinical trial of a new lightwand device (Trachlight) to intubate the trachea. Anesthesiology 1995; 83(3):509-14. Medline
|
|
I
|
Neutral (Yellow)
|
Success of airway management
|
Patient
|
PH-Paramedic
|
Jensen JL., Cheung KW., Tallon JM., Travers AH. Comparison of tracheal intubation and alternative airway techniques performed in the prehospital setting by paramedics: A systematic review. CJEM 2010; 12(2):135-40. Medline
|
|
I
|
Neutral (Yellow)
|
First pass success
|
Process
|
PH-Paramedic
|
Kent ME, Sciavolino BM, Blickley ZJ, Pasichow SH. Video laryngoscopy versus direct laryngoscopy for orotracheal intubation in the out-of-hospital environment: a systematic review and meta-analysis. Prehosp Emerg Care 2023; 1-16. Medline
|
|
I
|
Neutral (Yellow)
|
Failure of attempted airway
|
Process
|
|
Lewis SR., Butler AR., Parker J., Cook TM., Smith AF. Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation. The Cochrane database of systematic reviews 2016; 11:CD011136. Medline
|
|
I
|
Neutral (Yellow)
|
Increase in size of intracranial hemorrhage
|
Patient
|
ED-MD
|
Yu SH., Beirne OR. Laryngeal mask airways have a lower risk of airway complications compared with endotracheal intubation: a systematic review. J Oral Maxillofac Surg 2010; 68(10):2359-2376. Medline
|
|
II
|
Supportive (Green)
|
Intubation success rate
|
Process
|
|
Crewdson K., Lockey DJ., Røislien J., Lossius HM., Rehn M. The success of pre-hospital tracheal intubation by different pre-hospital providers: a systematic literature review and meta-analysis. Crit Care 2017; 21(1):31. Medline
|
|
II
|
Supportive (Green)
|
successful tracheal intubation (with first device)
|
Process
|
ED-MD
|
Michailidou M., O'Keeffe T., Mosier JM., et al. A comparison of video laryngoscopy to direct laryngoscopy for the emergency intubation of trauma patients. World J Surg 2015; 39(3):782-8. Medline
|
|
II
|
Supportive (Green)
|
First Pass Success
|
Process
|
PH-Paramedic
|
Pourmand A, Terrebonne E, Gerber S, Shipley J, Tran QK. Efficacy of Video Laryngoscopy versus Direct Laryngoscopy in the Prehospital Setting: A Systematic Review and Meta-Analysis. Prehosp Disaster Med Dec 2022; 1-11. Medline
|
|
II
|
Supportive (Green)
|
Number of attempts to intubate
|
Patient
|
PH-Paramedic
|
Wayne MA., McDonnell M. Comparison of traditional versus video laryngoscopy in out-of-hospital tracheal intubation. Prehosp Emerg Care 2010; 14(2):278-282. Medline
|
|
II
|
Neutral (Yellow)
|
Successful placement
|
Process
|
PH-Paramedic
|
Brown LH., Hubble MW., Wilfong DA., Hertelendy A., Benner RW. Airway management in the air medical setting. Air Med J 2011; 30(3):140-8. Medline
|
|
II
|
Neutral (Yellow)
|
Survival
|
Patient
|
PH-Paramedic & MD
|
Carney N, Totten AM, Cheney T, Jungbauer R, Neth MR, Weeks C, et al. Prehospital Airway Management: A Systematic Review. Prehosp Emerg Care 2021; 1–28. Medline
|
|
II
|
Neutral (Yellow)
|
Success, time
|
Process
|
OR
|
Cavus E., Deitmer W., Francksen H., Serocki G., Bein B., Scholz J., et al. Laryngeal tube S II, ProSeal laryngeal mask, and EasyTube during elective surgery: a randomized controlled comparison with the endotracheal tube in nontrained professionals. Eur J Anaesthesiol 2009; 26(9):730-35. Medline
|
|
II
|
Neutral (Yellow)
|
Prehospital time delay
|
Process
|
PH-Paramedic
|
Cudnik MT., Newgard CD., Wang H., Bangs C., Herrington R. Endotracheal intubation increases out-of-hospital time in trauma patients. Prehosp Emer Care 2007; 11:224-9. Medline
|
|
II
|
Neutral (Yellow)
|
Mortality
|
Patient
|
|
Fevang E., Perkins Z., Lockey D., Jeppesen E., Lossius HM. A systematic review and meta-analysis comparing mortality in pre-hospital tracheal intubation to emergency department intubation in trauma patients. Crit Care 2017; 21(1):192. Medline
|
|
II
|
Neutral (Yellow)
|
Success rate
|
Patient
|
PH-Paramedic
|
Hubble MW., Brown L., Wilfong DA., Hertelendy A., Benner RW., Richards ME. A meta-analysis of prehospital airway control techniques part I: Orotracheal and nasotracheal intubation success rates. Prehosp Emerg Care 2010; 14(3):377-401. Medline
|
|
II
|
Neutral (Yellow)
|
Hospital mortality
|
Patient
|
PH-Paramedic
|
Kempema J., Trust MD., Ali S., et al. Prehospital endotracheal intubation vs extraglottic airway device in blunt trauma. Am J Emerg Med 2015; 33(8):1080-3. Medline
|
|
II
|
Neutral (Yellow)
|
Intubation success rate
|
Process
|
PH-Paramedic
|
Lossius HM., Roislien J., Lockey DJ. Patient safety in pre-hospital emergency tracheal intubation: A comprehensive meta-analysis of the intubation success rates of EMS providers. Crit Care 2012; 16(1):R24. Medline
|
|
II
|
Neutral (Yellow)
|
Intubation success rate
|
Process
|
|
Myers LA., Gallet CG., Kolb LJ., Lohse CM., Russi CS. Determinants of Success and Failure in Prehospital Endotracheal Intubation. The Western Journal of Emergency Medicine 2016; 17(5):640-7. Medline
|
|
II
|
Neutral (Yellow)
|
30 day mortality
|
Patient
|
Other
|
Nichols M, Fouche PF, Bendall JC. Video versus direct laryngoscopy by specialist paramedics in New South Wales: Preliminary results from a new airway registry. Emerg Med Australas 2022. Medline
|
|
II
|
Neutral (Yellow)
|
Efficacy
|
Process
|
OR
|
Nishikawa K., Kawana S., Namiki A. Comparison of the lightwand technique with direct laryngoscopy for awake endotracheal intubation in emergency cases. J Clin Anesth 2001; 13(4):259-63. Medline
|
|
II
|
Neutral (Yellow)
|
In-hospital mortality
|
Patient
|
PH-Paramedic
|
Weigeldt M, Schulz-Drost S, Stengel D, Lefering R, Treskatsch S, Berger C. In-hospital mortality after prehospital endotracheal intubation versus alternative methods of airway management in trauma patients. A cohort study from the TraumaRegister DGU®. Eur J Trauma Emerg Surg. March 2024. Medline
|
|
II
|
Opposes (Red)
|
Intubation success, Oxygen saturation
|
Process
|
PH-Paramedic
|
Davis DP., et al. Predictors of intubation success and therapeutic value of paramedic airway management in a large, urban EMS system. Prehosp Emerg Care 2006; 10:356-62. Medline
|
|
II
|
Opposes (Red)
|
Survival to hospital discharge
|
Patient
|
PH-Paramedic & CCT
|
Fouche PF., Smith K., Jennings PA., Boyle M., Bernard S. The association of paramedic rapid sequence intubation and survival in out-of-hospital stroke. EMJ 2019; 36(7):416-22. Medline
|
|
II
|
Opposes (Red)
|
Complications
|
Patient
|
PH-Paramedic & MD
|
Ono Y., Kakamu T., Kikuchi H., Mori Y., Watanabe Y., Shinohara K. Expert-Performed Endotracheal Intubation-Related Complications in Trauma Patients Incidence, Possible Risk Factors, and Outcomes in the Prehospital Setting and Emergency Department. Emergency medicine international 2018; 2018 5649476. Medline
|
|
II
|
Opposes (Red)
|
Survival
|
Patient
|
PH-Paramedic
|
Stiell IG., et al. The OPALS Major Trauma Study: impact of advanced life-support on survival and morbidity. CMAJ 2008; 178:1141-52. Medline
|
|
II
|
Opposes (Red)
|
Mortality
|
Patient
|
PH-Paramedic
|
Stockinger ZT., McSwain NE. Prehospital Endotracheal Intubation for Trauma does not improve survival over bag-mask ventilation. J Trauma 2004; 56:531-6. Medline
|
|
III
|
Supportive (Green)
|
Success
|
Patient
|
PH-Paramedic
|
Wang HE., Kupas DF., Paris PM., Bates RR., Yealy DM. Preliminary experience with a prospective, multi-centered evaluation of out-of-hospital endotracheal intubation. Resus 2003; 58:49-58. Medline
|
|
III
|
Neutral (Yellow)
|
Functional of-hospital airway management in the United States
|
Patient
|
PH-Paramedic
|
Wang HE., Mann NC., Mears G., Jacobson K., Yealy D. Out-of-hospital airway management in the United States. Resuscitation 2011; 82(4):378–385. Medline
|
|
III
|
Opposes (Red)
|
Sensitivity and specificity
|
Process
|
PH-Paramedic
|
Pelucio M., Halligan L., Dhindsa H. Out-of-hospital experience with the syringe esophageal detector device. Acad Emerg Med 1997; 4:563-8. Medline
|
Video Visualization ( e.g. Glidescope)
| Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
|
I
|
Supportive (Green)
|
First pass success.
|
Process
|
ED-MD
|
Bhattacharjee S., Maitra S., Baidya DK. A comparison between video laryngoscopy and direct laryngoscopy for endotracheal intubation in the emergency department: A meta-analysis of randomized controlled trials. J Clin Anesth 2018; 47:21-6. Medline
|
|
I
|
Supportive (Green)
|
First pass success
|
Process
|
Other
|
Hansel J, Rogers AM, Lewis SR, Cook TM, Smith AF. Videolaryngoscopy versus direct laryngoscopy for adults undergoing tracheal intubation. Cochrane Database Syst Rev 2022; 4(4):CD011136. Medline
|
|
I
|
Supportive (Green)
|
Failure of attempted airway
|
Process
|
|
Lewis SR., Butler AR., Parker J., Cook TM., Smith AF. Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation. The Cochrane database of systematic reviews 2016; 11:CD011136. Medline
|
|
I
|
Neutral (Yellow)
|
Overall intubation success
|
Process
|
Other
|
Cavus E., Janssen S., Reifferscheid F., Caliebe A., Callies A., von der Heyden M., et al. Videolaryngoscopy for Physician-Based, Prehospital Emergency Intubation: A Prospective, Randomized, Multicenter Comparison of Different Blade Types Using A.P. Advance, C-MAC System, and KingVision. Anesth Analg 2018; 126(5):1565-74. Medline
|
|
I
|
Neutral (Yellow)
|
First pass success
|
Process
|
|
Driver BE., Prekker ME., Moore JC., Schick AL., Reardon RF., Miner JR. Direct Versus Video Laryngoscopy Using the C-MAC for Tracheal Intubation in the Emergency Department, a Randomized Controlled Trial. Academic emergency medicine 2016; 23(4):433-9 Medline
|
|
I
|
Neutral (Yellow)
|
Overall intubation success
|
Process
|
|
Goksu E., Kilic T., Yildiz G., Unal A., Kartal M. Comparison of the C-MAC video laryngoscope to the Macintosh laryngoscope for intubation of blunt trauma patients in the ED. Turkish journal of emergency medicine 2016; 16(2):53-56. Medline
|
|
I
|
Neutral (Yellow)
|
First pass success
|
Process
|
PH-Paramedic & MD
|
Hossfeld B, Thierbach S, Allgoewer A, Gaessler H, Helm M. First pass success of tracheal intubation using the C-MAC PM videolaryngoscope as first-line device in prehospital cardiac arrest compared with other emergencies: An observational study. Eur J Anaesthesiol 2021; 38(8):806–12. Medline
|
|
I
|
Neutral (Yellow)
|
First-attempt success rate
|
Process
|
Other
|
Jiang J., Ma D., Li B., Yue Y., Xue F. Video laryngoscopy does not improve the intubation outcomes in emergency and critical patients - a systematic review and meta-analysis of randomized controlled trials. Crit Care 2017; 21(1):288. Medline
|
|
I
|
Neutral (Yellow)
|
Survival to hospital discharge
|
Patient
|
ED-MD
|
Yeatts DJ., Dutton RP., Hu PF., et al. Effect of video laryngoscopy on trauma patient survival: A randomized controlled trial. J Trauma Acute Care Surg 2013; 75(2):212-219. Medline
|
|
I
|
Opposes (Red)
|
Success
|
Process
|
|
Trimmel H., Kreutziger J., Fitzka R., Szüts S., Derdak C., Koch E., et al. Use of the GlideScope Ranger Video Laryngoscope for Emergency Intubation in the Prehospital Setting: A Randomized Control Trial. Crit Care Med 2016; 44(7):e470-6. Medline
|
|
II
|
Supportive (Green)
|
Success
|
Process
|
OR
|
Ayoub. Tracheal intubation following training with Glidescope vs direct laryngoscopy. Anaesthesia 2010; 65:674-8. Medline
|
|
II
|
Supportive (Green)
|
Laryngeal view
|
Patient
|
PH-MD & CCT
|
Hossfeld B., Frey K., Doerges V., Lampl L., Helm M. Improvement in glottic visualisation by using the C-MAC PM video laryngoscope as a first-line device for out-of-hospital emergency tracheal intubation: An observational study. Eur J Anaesthesiol 2015; 32(6):425-31. Medline
|
|
II
|
Supportive (Green)
|
First pass success
|
Process
|
PH-Paramedic
|
Huebinger RM, Stilgenbauer H, Jarvis JL, Ostermayer DG, Schulz K, Wang HE. Video laryngoscopy for out of hospital cardiac arrest. Resuscitation 2021; 162:143-8. Medline
|
|
II
|
Supportive (Green)
|
Multiple measures of chest compression interruptions
|
Process
|
|
Jarman AF., Hopkins CL., Hansen JN., Brown JR., Burk C., Youngquist ST. Advanced Airway Type and Its Association with Chest Compression Interruptions During Out-of-Hospital Cardiac Arrest Resuscitation Attempts. Prehosp Emerg Care 2017; 21(5):628-35. Medline
|
|
II
|
Supportive (Green)
|
First pass success
|
Process
|
PH-Paramedic
|
Kent ME, Sciavolino BM, Blickley ZJ, Pasichow SH. Video laryngoscopy versus direct laryngoscopy for orotracheal intubation in the out-of-hospital environment: a systematic review and meta-analysis. Prehosp Emerg Care 2023; 1-16. Medline
|
|
II
|
Supportive (Green)
|
First pass success
|
Process
|
|
Lee JK., Kang H., Choi HJ. Changes in the first-pass success rate with the GlideScope video laryngoscope and direct laryngoscope: a ten-year observational study in two academic emergency departments. Clinical and Experimental Emergency Medicine 2016; 3(4):213-218. Medline
|
|
II
|
Supportive (Green)
|
First-pass success
|
Process
|
PH-MD & CCT
|
Maissan I, van Lieshout E, de Jong T, van Vledder M, Houmes RJ, Hartog DD, Stolker RJ. The impact of video laryngoscopy on the first-pass success rate of prehospital endotracheal intubation in The Netherlands: a retrospective observational study. Eur J Trauma Emerg Surg 2022. Medline
|
|
II
|
Supportive (Green)
|
Successful tracheal intubation (with first device)
|
Process
|
ED-MD
|
Michailidou M., O'Keeffe T., Mosier JM., et al. A comparison of video laryngoscopy to direct laryngoscopy for the emergency intubation of trauma patients. World J Surg 2015; 39(3):782-8. Medline
|
|
II
|
Supportive (Green)
|
Discharge with good neurological outcome
|
Patient
|
PH-Paramedic & MD
|
Risse J, Fischer M, Meggiolaro KM, Fariq-Spiegel K, Pabst D, et al. Effect of video laryngoscopy for non-trauma out-of-hospital cardiac arrest on clinical outcome: A registry-based analysis. Resuscitation 2023; 109688. Medline
|
|
II
|
Supportive (Green)
|
Survival to hospital admission
|
Patient
|
PH-Paramedic
|
Ryan KM, Bui MD, Dugas JN, Zvonar I, Tobin JM. Impact of prehospital airway interventions on outcome in cardiac arrest following drowning: A study from the CARES Surveillance Group. Resuscitation 2021; 163:130–5. Medline
|
|
II
|
Supportive (Green)
|
First-pass intubation success
|
Process
|
|
Savino PB., Reichelderfer S., Mercer MP., Wang RC., Sporer KA. Direct Versus Video Laryngoscopy for Prehospital Intubation: A Systematic Review and Meta-analysis. Academic Emergency Medicine 2017; 24(8):1018-26. Medline
|
|
II
|
Supportive (Green)
|
First pass success
|
Patient
|
PH-Paramedic & CCT
|
von Vopelius-Feldt, J., Peddle, M., Lockwood, J. et al. The effect of a multi-faceted quality improvement program on paramedic intubation success in the critical care transport environment: a before-and-after study. Scand J Trauma Resusc Emerg Med 31, 9 (2023). https://doi.org/10.1186/s13049-023-01074-0 Medline
|
|
II
|
Supportive (Green)
|
Number of attempts to intubate
|
Patient
|
PH-Paramedic
|
Wayne MA., McDonnell M. Comparison of traditional versus video laryngoscopy in out-of-hospital tracheal intubation. Prehosp Emerg Care 2010; 14(2):278-282. Medline
|
|
II
|
Neutral (Yellow)
|
First pass success
|
Patient
|
Other
|
Arulkumaran N., Lowe J., Ions R., Mendoza M., Bennett V., Dunser MW. Videolaryngoscopy versus direct laryngoscopy for emergency orotracheal intubation outside the operating room: a systematic review and meta-analysis. Br J Anaesth 2018; 120(4):712-24. Medline
|
|
II
|
Neutral (Yellow)
|
Study noted reasons for failed intubation attempts
|
Process
|
PH-Paramedic & MD
|
Ljungquist HE, Nurmi JO. Reasons behind failed prehospital intubation attempts while combining C-MAC videolaryngoscope and Frova introducer. Acta Anaesthesiol Scand 2021. Medline
|
|
II
|
Neutral (Yellow)
|
First-pass success
|
Process
|
PH-Paramedic
|
Pourmand A, Terrebonne E, Gerber S, Shipley J, Tran QK. Efficacy of Video Laryngoscopy versus Direct Laryngoscopy in the Prehospital Setting: A Systematic Review and Meta-Analysis. Prehosp Disaster Med Dec 2022; 1-11. Medline
|
|
II
|
Neutral (Yellow)
|
VL first-pass success
|
Patient
|
ED-MD
|
Trent SA, Kaji AH, Calson JN, McCormick T, Haukoos JS, 3rd Brown CA. Video Laryngoscopy Is Associated With First-Pass Success in Emergency Department Intubations for Trauma Patients: A Propensity Score Matched Analysis of the National Emergency Airway Registry. Ann Emerg Med 2021; 78(6):708–19. Medline
|
|
III
|
Supportive (Green)
|
Time to success
|
Process
|
|
Bahathiq AO., Abdelmontaleb TH., Newigy MK. Learning and performance of endotracheal intubation by paramedical students: Comparison of GlideScope(®) and intubating laryngeal mask airway with direct laryngoscopy in manikins. Indian J Anaesth 2016; 60(5):337-42. Medline
|
|
III
|
Supportive (Green)
|
Time to insertion
|
Process
|
|
Butchart AG., Tjen C., Garg A., Young P. Paramedic laryngoscopy in the simulated difficult airway: Comparison of the venner A.P. advance and GlideScope ranger video laryngoscopes. Acad Emerg Med 2011; 18(7):692-8. Medline
|
|
III
|
Supportive (Green)
|
ETT first pass success
|
Process
|
Other
|
Chien YT, Ong JR, Tam KW, Loh EW. Video laryngoscopy and direct laryngoscopy for cardiac arrest: A meta-analysis of clinical studies and trials. Am J Emerg Med August 2023; 73:116-124. Medline
|
|
III
|
Supportive (Green)
|
Successful intubation
|
Process
|
SIM
|
Cinar O., Cevik E., Yildirim AO., Yasar M., Kilic E., Comert B. Comparison of GlideScope video laryngoscope and intubating laryngeal mask airway with direct laryngoscopy for endotracheal intubation. Eur J Emerg Med 2011; 18(2):117-20. Medline
|
|
III
|
Supportive (Green)
|
First Pass Success
|
Process
|
|
Ducharme S., Kramer B., Gelbart D., Colleran C., Risavi B., Carlson JN. A pilot, prospective, randomized trial of video versus direct laryngoscopy for paramedic endotracheal intubation. Resuscitation 2017; 114:121-126. Medline
|
|
III
|
Supportive (Green)
|
Time to visualization of glottic opening
|
Process
|
|
Eismann H., Sieg L., Etti N., Friedrich L., Schröter C., Mommsen P., et al. Improved success rates using videolaryngoscopy in unexperienced users: a randomized crossover study in airway manikins. Eur J Med Res 2017; 22(1):27. Medline
|
|
III
|
Supportive (Green)
|
Time to intubation
|
Process
|
|
Gawlowski P., Smereka J., Madziala M., Cohen B., Ruetzler K., Szarpak L. Comparison of the ETView Single Lumen and Macintosh laryngoscopes for endotracheal intubation in an airway manikin with immobilized cervical spine by novice paramedics: A randomized crossover manikin trial. Medicine 2017; 96(16):e5873. Medline
|
|
III
|
Supportive (Green)
|
Overall success rate
|
Process
|
SIM
|
Kaplan A., Goksu E., Yildiz G., Kilic T. Comparison of the C-MAC videolaryngoscope and rigid fiberscope with direct laryngoscopy in easy and difficult airway scenarios: A manikin study. J Emerg Med. 2016;50(3):e107-14. Medline
|
|
III
|
Supportive (Green)
|
First pass success
|
Patient
|
PH-Paramedic & MD
|
Knapp J, Eberle B, Bernhard M, Theiler L, Pietsch U, Albrecht R. Analysis of tracheal intubation in out-of-hospital helicopter emergency medicine recorded by video laryngoscopy. Scand J Trauma Resusc Emerg Med 2021; 29(1):49. Medline
|
|
III
|
Supportive (Green)
|
Agitation scale
|
Patient
|
In-Patient
|
Kovacs G., et al. A Comparison on a fiberoptic stylet and a bougie as adjuncts to direct laryngoscopy in a manikin-simulated difficult airway. Ann Emerg Med 2007; 50:676-85. Medline
|
|
III
|
Supportive (Green)
|
Intubation success
|
Process
|
SIM
|
Lewis AR., Hodzovic I., Whelan J., Wilkes AR., Bowler I., Whitfield R. A paramedic study comparing the use of the Airtraq, Airway Scope and Macintosh laryngoscopes in simulated prehospital airway scenarios. Anaesthesia 2010; 65(12):1187-93. Medline
|
|
III
|
Supportive (Green)
|
Intubation success
|
Process
|
SIM
|
Liu L., Tanigawa K., Kusunoki S., Tamura T., Ota K., Yamaga S., et al. Tracheal intubation of a difficult airway using Airway Scope, Airtraq, and Macintosh laryngoscope: A comparative manikin study of inexperienced personnel. Anesth Analg 2010; 110(4):1049-55. Medline
|
|
III
|
Supportive (Green)
|
Intubation success
|
Process
|
SIM
|
Nasim S., Maharaj CH., Malik MA., O'Donnell J., Higgins BD., Laffey JG. Comparison of the glidescope and pentax AWS laryngoscopes to the macintosh laryngoscope for use by advanced paramedics in easy and simulated difficult intubation. BMC Emerg Med 2009; 9:9-227X. Medline
|
|
III
|
Supportive (Green)
|
Successful endotracheal intubation
|
Process
|
PH-Paramedic
|
Nichols M, Fouche PF, Bendall JC. Video versus direct laryngoscopy by specialist paramedics in New South Wales: Preliminary results from a new airway registry. Emerg Med Australas 2022. Medline
|
|
III
|
Supportive (Green)
|
Intubation success
|
Process
|
OR
|
Noppens RR. Evaluation of the McGrath Video laryngoscope after failed direct laryngoscope. Anaesthesia 2010; 65:716-20. Medline
|
|
III
|
Supportive (Green)
|
Successful endotracheal intubation
|
Process
|
SIM
|
Ratajczyk P, Dolder P, Szmyd B, et al. Comparison of UESCOPE VL 400, I-View, Non-Channeled Airtraq Videolaryngoscopes and Macintosh Laryngoscope for Tracheal Intubation in Simulated Out-of-Hospital Conditions: A Randomized Crossover Manikin Study. Healthc February 2024; 12(4). Medline
|
|
III
|
Supportive (Green)
|
Endotracheal intubation (ETI) attempts, success rates
|
Patient
|
|
Thomas S., Judge T., Lowell MJ., et al. Airway management success and hypoxemia rates in air and ground critical care transport: A prospective multicenter study. Prehosp Emerg Care 2010; 14(3):283. Medline
|
|
III
|
Supportive (Green)
|
Success rate
|
Process
|
|
Yildirim A., Kiraz HA., Ağaoğlu, Akdur O. Comparison of Macintosh, McCoy and C-MAC D-Blade video laryngoscope intubation by prehospital emergency health workers: a simulation study. Intern Emerg Med 2017; 12(1):91-97. Medline
|
|
III
|
Neutral (Yellow)
|
Success rate
|
Process
|
SIM
|
Amathieu R., Sudrial J., Abdi W., Luis D., Hahouache H., Combes X., et al. Simulating face-to-face tracheal intubation of a trapped patient: a randomized comparison of the LMA Fastrach™, the GlideScope™, and the Airtraq™ laryngoscope. Br J Anaesth 2012; 108(1):140-5. Medline
|
|
III
|
Neutral (Yellow)
|
Time to successful completion of ETI
|
Process
|
SIM
|
Castaneda P, Kim TS, Beck JD, Cronin AJ, Monti KS, Wagner EM, et al. Special Operations Medics Test the Novel iView Video Laryngoscope: A Prospective, Randomized, Crossover Trial. Med J (Ft Sam Houst Tex) 2021(8-21):44-51. Medline
|
|
III
|
Neutral (Yellow)
|
First pass success rate
|
Process
|
|
Hafner JW., Perkins BW., Korosac JD., Bucher AK., Aldag JC., Cox KL. Intubation Performance of Advanced Airway Devices in a Helicopter Emergency Medical Service Setting. Air Med J 2016; 35(3):132-7. Medline
|
|
III
|
Neutral (Yellow)
|
Success rate of endotracheal intubation
|
Process
|
|
Kim JW., Park SO., Lee KR., Hong DY., Baek KJ., Lee YH., et al. Video laryngoscopy vs. direct laryngoscopy: Which should be chosen for endotracheal intubation during cardiopulmonary resuscitation? A prospective randomized controlled study of experienced intubators. Resuscitation 2016; 105:196-202. Medline
|
|
III
|
Neutral (Yellow)
|
First pass success
|
Patient
|
PH-Paramedic & CCT
|
Lenz T, Olsen J. Direct Versus Video Laryngoscopy in a Helicopter Emergency Medical Services Setting: A Retrospective Comparison. Air Med J 2021; 40(6):427–30. Medline
|
|
III
|
Neutral (Yellow)
|
Success rate
|
Process
|
|
Pieters BM., Wilbers NE., Huijzer M., Winkens B., van Zundert AA. Comparison of seven videolaryngoscopes with the Macintosh laryngoscope in manikins by experienced and novice personnel. Anaesthesia 2016; 71(5):556-64. Medline
|
|
III
|
Neutral (Yellow)
|
ETI success rate
|
Patient
|
OR
|
Putz L., Dangelser G., Constant B., Jamart J., Collard E., Maes M., et al. Prospective trial comparing Airtraq and Glidescope techniques for intubation of obese patients. Ann Fr Anesth Reanim 2012; 31(5):421-6. Medline
|
|
III
|
Neutral (Yellow)
|
Time to intubation
|
Process
|
|
Truszewski Z., Czyzewski L., Smereka J., Krajewski P., Fudalej M., Madziala M., et al. Ability of paramedics to perform endotracheal intubation during continuous chest compressions: a randomized cadaver study comparing Pentax AWS and Macintosh laryngoscopes. Am J Emerg Med 2016; 34(9):1835-9. Medline
|
|
III
|
Neutral (Yellow)
|
Time to intubation
|
Process
|
|
Yousif S., Machan JT., Alaska Y., Suner S. Airway Management in Disaster Response: A Manikin Study Comparing Direct and Video Laryngoscopy for Endotracheal Intubation by Prehospital Providers in Level C Personal Protective Equipment. Prehosp Disaster Med 2017; 32(4):352-356. Medline
|
|
III
|
Neutral (Yellow)
|
Time to successful ventilation
|
Process
|
SIM
|
Yun BJ., Brown CA.,3rd, Grazioso CJ., Pozner CN., Raja AS. Comparison of video, optical, and direct laryngoscopy by experienced tactical paramedics. Prehosp Emerg Care 2014; 18(3):442-445. Medline
|
|
X
|
Not Yet Graded (White)
|
-
|
|
|
Schauer SG, Long BJ, April MD, et al. A prospective, pragmatic non-inferiority study of emergency intubation success with the single-use i-view versus standard reusable video laryngoscope. Transfusion May 2024; 64 Suppl 2:S201-9. Medline
|