Prehospital Videolaryngoscope Availability and Use in Belgium: A Nationwide Cross-Sectional Survey

BackgroundEmergency endotracheal intubation (ETI) outside the operating room is challenging because of patient-, operator-, situational-, and logistical factors.Videolaryngoscopy is an alternative to direct laryngoscopy and can reduce ETI failure and complications.In Belgium, no published data are available regarding the availability of videolaryngoscopes (VL) for prehospital ETI by mobile intensive care unit (MICU) crews.The main objective of this survey was to estimate VL availability among responding Belgian MICUs.The secondary objective was to identify physicians' prehospital VL use patterns as well as to explore factors potentially associated with VL use. MethodsThis cross-sectional survey used two online questionnaires distributed to all Belgian MICUs.Questionnaire A was intended for the heads of department and collected information about VL availability and local protocols.Questionnaire B was intended for all MICU physicians and assessed their frequency of VL use and their reasons for using it or not using it. ResultsOf the 96 eligible Belgian MICUs, 35 heads of department responded to Questionnaire A (36.5%) and 32/35 (91.4%; 95% confidence interval, CI, 77.6-97.0%)reported VL availability.Out of the 115 MICU physicians who responded to Questionnaire B, 81 reported using a VL (70.4%; 95% CI, 61.5-78.0%).Among respondents with access to a VL, reported use differed by region of practice (p = 0.012); odds of VL use were lower in the Brussels-Capital Region (odds ratio 0.123; 95% CI, 0.028-0.546).More than half of the VL users reported using it for less than 10% of their ETIs, and only 6.2% used it as a first-choice device.The most frequently reported indication for VL use was failed ETI with a direct laryngoscope (81.5%). ConclusionVL availability was high among responding Belgian MICUs.However, the reported prehospital VL use was infrequent.