Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Canadian Journal of Anesthesia/Journal canadien d'anesthésie
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 11/2021

01-11-2021 | Reports of Original Investigations

Comparison of the strength of various disposable videolaryngoscope blades

Authors: Jongbong Choi, BEng, Yeongtak Song, PhD, Heekyung Lee, MD, Yongil Cho, MD, PhD, Tae Hee Han, MD, PhD, Tae Ho Lim, MD, PhD

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 11/2021

Login to get access

Abstract

Purpose

Breaking of disposable blades during emergency endotracheal intubation has been reported. Breakage can cause serious injury and foreign body ingestion. We aimed to measure and analyze the strength characteristics of different disposable videolaryngoscope blades with the application of an upward-lifting force.

Methods

We measured the strength of four disposable videolaryngoscope blades (C-Mac® S Video laryngoscope MAC #3, Glidescope GVL® 3 stat, Pentax AWS® PBlade TL type, and King Vision® aBlade #3) using the fracture test. The strength of 12 samples of each type of disposable videolaryngoscope blade was measured using an Instron 5,966 tensile tester by applying an upward-lifting force.

Results

After the fracture test using C-Mac, Glidescope GVL, Pentax AWS, and King Vision, the number of deformed blades were 0, 12, 3, and 7, respectively, and the number of broken blades were 12, 0, 9, and 5, respectively. The mean (standard deviation) maximum force strengths of Pentax AWS, C-Mac, King Vision, and Glidescope GVL blades were 408.4 (27.4) N, 325.8 (26.5) N, 291.8 (39.3) N, and 262.7 (3.8) N, respectively (P < 0.001).

Conclusion

Clinicians should be aware of the varied strength characteristics of the four types of disposable videolaryngoscope blades when they are used in endotracheal intubation.
Appendix
Available only for authorised users
Literature
1.
Chemsian R, Bhananker S, Ramaiah R. Videolaryngoscopy. Int J Crit Illn Inj Sci 2014; 4: 35-41.CrossRef
2.
Jones PM, Armstrong KP, Armstrong PM, et al. A comparison of GlideScope® videolaryngoscopy to direct laryngoscopy for nasotracheal intubation. Anesth Analg 2008; 107: 144-8.CrossRef
3.
4.
Nouruzi-Sedeh P, Schumann M, Groeben H. Laryngoscopy via Macintosh Blade versus GlideScope: success rate and time for endotracheal intubation in untrained medical personnel. Anesthesiology 2009; 110: 32-7.CrossRef
5.
Shimada M, Hirabayashi Y, Seo N. Nasotracheal intubation using GlideScope videolaryngoscope or Macintosh laryngoscope by novice laryngoscopists (Japanese). Masui 2010; 59: 1318-20.PubMed
6.
Law JA, Broemling N, Cooper RM, et al. The difficult airway with recommendations for management–part 1–difficult tracheal intubation encountered in an unconscious/induced patient. Can J Anesth 2013; 60: 1089-18.CrossRef
7.
Ballin MS, McCluskey A, Maxwell S, Spilsbury S. Contamination of laryngoscopes. Anaesthesia 1999; 54: 1115-6.CrossRef
8.
Ayliffe GA. Sterilization, disinfection and cleaning of medical equipment: guidance on decontamination from the Microbiology Advisory Committee to Department of Health Medical Devices Directorate. Part I principles. J Hosp Infect 1995; 29: 322-4.CrossRef
9.
Miller DM, Youkhana I, Karunaratne WU, Pearce A. Presence of protein deposits on ‘cleaned’ re-usable anaesthetic equipment: apparatus. Anaesthesia 2001; 56: 1069-72.CrossRef
10.
Rutala WA, Weber DJ; Healthcare Infection Control Practice Advisory Committee (HICPAC). Guideline for disinfection and sterilization in healthcare facilities; 2008; latest update May 2019. Centers for Disease Control and Prevention. Available from URL: https://​stacks.​cdc.​gov/​view/​cdc/​47378 (accessed June 2021).
11.
Sherman JD, Hopf HW. Balancing infection control and environmental protection as a matter of patient safety: the case of laryngoscope handles. Anesth Analg 2018; 127: 576-9.CrossRef
12.
Sherman JD, Raibley LA 4th, Eckelman MJ. Life cycle assessment and costing methods for device procurement: comparing reusable and single-use disposable laryngoscopes. Anesth Analg 2018; 127: 434-43.CrossRef
13.
Sherman J. Reusable vs. disposable laryngoscopes. Anesthesaia Patient Safety Foundation Newsletter 2019; 33: 91.
14.
Howell V, Thoppil A, Young H, Sharma S, Blunt M, Young P. Chlorhexidine to maintain cleanliness of laryngoscope handles: an audit and laboratory study. Eur J Anaesthesiol 2013; 30: 216‐21.CrossRef
15.
Amour J, Le Manach Y, Borel M, et al. Comparison of single-use and reusable metal laryngoscope blades for orotracheal intubation during rapid sequence induction of anesthesia: a multicenter cluster randomized study. Anesthesiology 2010; 112: 325-32.CrossRef
16.
Evans A, Vaughan RS, Hall JE, Mecklenburgh J, Wilkes AR. A comparison of the forces exerted during laryngoscopy using disposable and non-disposable laryngoscope blades. Anaesthesia 2003; 58: 869-73.CrossRef
17.
Gaszynski TM. Forces applied by the laryngoscope blade onto the tongue during intubation attempts: a comparison between Mackintosh, AirTraq and Pentax AWS in a mannequin study. Eur J Anaesthesiol 2011; 28: 463-4.CrossRef
18.
Rassam S, Wilkes AR, Hall JE, Mecklenburgh JS. A comparison of 20 laryngoscope blades using an intubating manikin: visual analogue scores and forces exerted during laryngoscopy. Anaesthesia 2005; 60: 384-94.CrossRef
19.
Lee C, Russell T, Firat M, Cooper RM. Forces generated by Macintosh and GlideScope® laryngoscopes in four airway-training manikins. Anaesthesia 2013; 68: 492-6.CrossRef
20.
Russell T, Khan S, Elman J, Katznelson R, Cooper RM. Measurement of forces applied during Macintosh direct laryngoscopy compared with GlideScope® videolaryngoscopy. Anaesthesia 2012; 67: 626-31.CrossRef
21.
Twigg SJ, McCormick B, Cook TM. Randomized evaluation of the performance of single-use laryngoscopes in simulated easy and difficult intubation. Br J Anaesth 2003; 90: 8-13.CrossRef
22.
Goodwin N, Wilkes A, Hall JE. Strength of disposable laryngoscope blades. Anaesthesia 2005; 60: 630-1.CrossRef
23.
Panacek EA, Laurin EG, Bair AE. Fracture of a GlideScope® cobalt GVL® Stat disposable blade during an emergency intubation. J Emerg Med 2012; 42: e125-8.CrossRef
24.
Jefferson P, Perkins V, Edwards VA, Ball DR. Problems with disposable laryngoscope blades. Anaesthesia 2003; 58: 385-6.CrossRef
25.
Yanovski B, Soroka G, Khalaila J, Charco Mora P, Gaitini L, Vaida S. Fracture of a GlideScope cobalt blade. Anaesthesia 2012; 67: 190-1.CrossRef
26.
Hensley M. An incident of GlideScope® stat cover failure. Anesthesia Patient Safety Foundation Newsletter 2020; 35: 14.
27.
Czichos H, Saito T, Smith L. Springer Handbook of Materials Measurement Methods. Vol 978. Springer; 2006.
28.
Kruskal WH, Wallis WA. Use of ranks in one-criterion variance analysis. J Am Stat Assoc 1952; 47: 583-621.CrossRef
29.
Bishop MJ, Harrington RM, Tencer AF. Force applied during tracheal intubation. Anesth Analg 1992; 74: 411-4.CrossRef
30.
Hastings RH, Hon ED, Nghiem C, Wahrenbrock EA. Force and torque vary between laryngoscopists and laryngoscope blades. Anesth Analg 1996; 82: 462-8. PubMed
31.
Caesar CG, Scott DH. Strength of disposable laryngoscopes. Anaesthesia 2004; 59: 1144-5.CrossRef
32.
33.
Maruyama K, Yamada T, Kawakami R, Hara K. Randomized cross-over comparison of cervical-spine motion with the AirWay Scope or Macintosh laryngoscope with in-line stabilization: a video-fluoroscopic study. Br J Anaesth 2008; 101: 563-7.CrossRef
34.
Bucx MJ, Scheck PA, Van Geel RT, Den Ouden AH, Niesing R. Measurement of forces during laryngoscopy. Anaesthesia 1992; 47: 348-1CrossRef
Metadata
Title
Comparison of the strength of various disposable videolaryngoscope blades
Authors
Jongbong Choi, BEng
Yeongtak Song, PhD
Heekyung Lee, MD
Yongil Cho, MD, PhD
Tae Hee Han, MD, PhD
Tae Ho Lim, MD, PhD
Publication date
01-11-2021
Publisher
Springer International Publishing
Published in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 11/2021
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-021-02069-0

Other articles of this Issue 11/2021

Canadian Journal of Anesthesia/Journal canadien d'anesthésie 11/2021 Go to the issue

Editorials

Use of nitrous oxide in contemporary anesthesia—an ongoing tug of war

Correspondence

Emergency awake fibreoptic intubation with confirmed COVID-19

Correspondence

Difficult extubation in the presence of methylene blue around the endotracheal tube cuff

Reports of Original Investigations

Intraoperative end-tidal carbon dioxide and postoperative mortality in major abdominal surgery: a historical cohort study

Reports of Original Investigations

Pulmonary artery catheterization in patients with cardiogenic shock: a systematic review and meta-analysis

Correction

Correction to: Diagnostic performance and clinical application of preoperative COVID-19 bedside testing with ID NOW™