Emergency intubation with video laryngoscope in a hospital setting.

Mastering Emergency Intubation: How Video Laryngoscopy Can Help

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Soraya Malik in Health & Wellness April 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.

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