A manikin study comparing the performance of traditional Macintosh laryngoscope, GlideScope®, Bonfils rigid intubation endoscope® and Video Stylet

Abstract Introduction Endoscopic intubation is an essential skill for emergency physicians. Difficult intubation is a challenging scenario. This study aims to evaluate the performance of Bonfils® (BF) compared with traditional Macintosh laryngoscope (DL), GlideScope® and Video Style (VS). Methods This is a pilot manikin study with sampling of 30 emergency physicians working in a local emergency center. Their performance of using traditional Macintosh laryngoscope, GlideScope®, BF and VS were compared in three situations: normal, restricted cervical motion and limited oral aperture. The time for intubation, first attempt success rate, failure rate, dental injury rate and the subjective ease of different devices by the participants were analyzed. Results In both the scenario with restricted neck motion and mouth aperture, BF and VS had the highest success at first attempt rate. The difference in the first attempt success rate was significantly different in the scenario with restricted neck motion. The mean intubation time by BF was similar to other devices. Intubation with BF had no dental injuries among all of the scenarios. The difference was statistically significant in the restricted cervical motion scenario and limited oral aperture scenario. (Restricted cervical motion: p = 0.012; limited oral aperture scenario: p < 0.001). BF had a statistically significantly better subjective score rated by participants when compared to each device in the limited mouth aperture scenario and higher than DL in restricted neck motion scenario. Conclusion We have demonstrated that BF had good performance in terms of least dental injury rate and highest first attempt success rate. The intubation time had no statistically significant difference compared to DL and GS.