[Out-of-hospital airway management in trauma patients : Experiences with the C-MAC® video laryngoscope].

BACKGROUND: Securing the airway is the top priority in trauma resuscitation. The most important factor for successful endotracheal intubation (ETI) is good visualization of the vocal cords. The aim of this study was to summarize the practical experiences with the C-MAC® video laryngoscope as initial device in out-of-hospital airway management of trauma patients.

METHODS: The C-MAC® video laryngoscope uses standard Macintosh shaped laryngoscope blades. At the Helicopter Emergency Medical Service (HEMS) Christoph 22 it is used as the initial device for every out-of-hospital ETI. All prehospital data on ETI involving trauma patients were documented for a period of 17 months.

RESULTS: A total of 116 out-of-hospital ETIs were enrolled in this study (overall success rate 100 %). In 88.8 % the first attempt was successful, whereas in 10.3 % a second and in 0.9 % a third ETI attempt was necessary. No patient required alternative airway devices or surgical airway interventions. The results of a subgroup with an immobilized cervical spine (n = 17) did not show any increased difficulties.

CONCLUSION: The use of the C-MAC® video laryngoscope by experienced anesthesiologists in an out-of-hospital setting seems to be a safe method even in patients with an immobilized cervical spine. Adverse laryngoscopy results (C/L III and IV) were reduced compared to other studies.