Emergency intubation with video laryngoscope in a hospital setting.

Mastering Emergency Intubation: How Video Laryngoscopy Can Help

Soraya Malik in Health & Wellness August 2025 • 4 min read.

"A new study reveals video laryngoscopy is a safe training tool for direct laryngoscopy technique in the emergency department for medical residents."

In emergency medicine, securing a patient's airway through endotracheal intubation (ETI) is a critical, often life-saving procedure. Traditionally, direct laryngoscopy (DL) has been the go-to technique. However, mastering DL requires significant skill and hands-on training, particularly for medical residents in the high-pressure environment of the emergency department (ED).

One of the biggest challenges in teaching DL is ensuring that both the instructor and the trainee have the same view of the patient's anatomy. Without a shared perspective, providing real-time feedback and guidance becomes difficult. This is where video laryngoscopy (VL) steps in, offering a potential solution to enhance training and improve patient outcomes.

While VL has gained popularity, conventional DL remains a common method for emergency intubation. The balance between adopting new technologies and maintaining proficiency in established techniques is essential. A recent study investigates how video laryngoscopy can serve as a valuable training tool for direct laryngoscopy in the ED, enhancing both resident education and patient safety.

C-MAC Video Laryngoscopy: A Game Changer in ED Training?

Emergency intubation with video laryngoscope in a hospital setting.

A study published in PLOS One explores the usefulness of the C-MAC video laryngoscope in direct laryngoscopy training within the emergency department. The researchers conducted a retrospective analysis of an institutional airway registry, focusing on adult patients (18 years and older) who underwent endotracheal intubation (ETI) between April 2014 and October 2016. The study aimed to determine if using the C-MAC video laryngoscope as a training tool could improve the success and safety of direct laryngoscopy performed by medical residents.

In the study, the operators used the C-MAC as a direct laryngoscope (DL) with limited access to the screen. During the procedure, a supervisor watched the screen and provided verbal feedback to instruct the operator. Patients were divided into two groups: the DL group, where conventional direct laryngoscopy was used, and the C-DL group, where the C-MAC was used as a DL.

The study focused on key areas:

First-pass success rates
Number of intubation attempts
Overall complication rates

The study revealed compelling results. In propensity score-matched groups, the first-pass success rate was 69% overall, but it was significantly higher in the C-DL group (79%) compared to the DL group (65%). Overall, multiple attempts were required in 8% of patients, with a notable difference between the C-DL group (4%) and the DL group (9%). The overall complication rate was 11%, with a lower rate in the C-DL group (4%) compared to the DL group (14%). Multivariable analysis confirmed that C-DL use was associated with higher first-pass success, fewer multiple attempts, and fewer complications.

The Future of Airway Management Training

This study suggests that C-MAC video laryngoscopy can be a valuable asset in training medical residents in direct laryngoscopy within the emergency department. By providing a shared visual field and real-time feedback, the C-MAC enhances both the learning experience and patient safety. While further research is needed to validate these findings, the integration of video laryngoscopy into emergency intubation training holds promising potential for the future of airway management.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1371/journal.pone.0208077, Alternate LINK

Title: Usefulness Of C-Mac Video Laryngoscope In Direct Laryngoscopy Training In The Emergency Department: A Propensity Score Matching Analysis

Subject: Multidisciplinary

Journal: PLOS ONE

Publisher: Public Library of Science (PLoS)

Authors: Sung Yeon Hwang, Se Uk Lee, Tae Rim Lee, Hee Yoon, Joo Hyun Park, Won Chul Cha, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Seonwoo Kim, Sun-Young Baek, Tae Gun Shin

Published: 2018-12-12

Everything You Need To Know

What is endotracheal intubation and why is direct laryngoscopy important in emergency medicine?

Endotracheal intubation (ETI) is a vital procedure performed in emergency medicine to secure a patient's airway. Direct laryngoscopy (DL) is the traditional technique used for this purpose. However, DL requires considerable skill and training, particularly for medical residents working in the high-pressure setting of the emergency department (ED).

How does video laryngoscopy address the challenges of teaching direct laryngoscopy to medical residents?

Video laryngoscopy (VL) addresses a significant challenge in direct laryngoscopy (DL) training by offering a shared visual field. This shared perspective allows instructors to provide real-time feedback and guidance to trainees, enhancing the learning experience and potentially improving patient outcomes. The C-MAC video laryngoscope is particularly useful in this regard.

What were the key findings regarding the use of the C-MAC video laryngoscope as a training tool for direct laryngoscopy?

The C-MAC video laryngoscope, when used as a direct laryngoscope (DL) with screen viewing by a supervisor, improves first-pass success rates during endotracheal intubation (ETI). A study showed a higher first-pass success rate in the C-DL group (79%) compared to the traditional DL group (65%). It also reduces the number of intubation attempts and lowers the overall complication rates.

What methodology was used in the PLOS One study to evaluate the effectiveness of the C-MAC in direct laryngoscopy training?

The study published in PLOS One retrospectively analyzed adult patients who underwent endotracheal intubation (ETI). Patients were divided into two groups: the DL group, using conventional direct laryngoscopy, and the C-DL group, where the C-MAC was used as a DL. The study measured first-pass success rates, the number of intubation attempts, and complication rates to assess the C-MAC's effectiveness as a training tool.

What aspects of emergency airway management were not covered in the study regarding the C-MAC video laryngoscope, and what further research is needed?

While the study focuses on the benefits of the C-MAC video laryngoscope in direct laryngoscopy (DL) training, it does not delve into the specific challenges of managing difficult airways or the role of other advanced airway management techniques such as the use of bougies, laryngeal mask airways (LMAs), or surgical airways like cricothyrotomy. Further research is needed to determine how video laryngoscopy integrates with these other essential aspects of emergency airway management, ensuring comprehensive training for medical residents.