Page 29 - JSOM Winter 2021

FIGURE 1 Example of the i-view video laryngoscope used in this FIGURE 2 Image of the SynDaver airway trainer used in this study.
study.

offers additional benefits with respect to US military property
accountability and reporting.

Goals of the Investigation
SUPPLEMENTAL FIGURE 1 Flight simulator with dual patient
We obtained end-user performance and survey feedback on setup.
the i-view video laryngoscope as a potential solution for im-
proving intubations during flight transport.

Methods
Ethics
The US Army Institute of Surgical Research regulatory office
reviewed protocol H-19-029 and determined it was exempt
from Institutional Review Board oversight. This office ap-
proved a consent documentation waiver; we provided consent
information sheets along with a briefing. We obtained ap-
proval from their chain of command prior to recruiting.

Subjects and Setting
We enrolled flight medics and flight medical officers at the
with the 3rd Battalion 160th Special Operations Aviation Reg-
iment (SOAR) at Hunter Army Airfield in Savanna, Georgia.
The medical personnel completed their initial entry training
and were assigned to the unit full-time. SUPPLEMENTAL FIGURE 2 Flight simulator.

Protocol
We worked with the battalion surgeon (WLW) and set up a
date and time for enrollment. An emergency medicine phy-
sician study team member provided a demonstration of in-
tubation using the i-view (Figure 1) on the SynDaver (www
.syndaver.com) airway trainer model (Figure 2), along with
a brief overview of troubleshooting an ETI while using the
i-view. All participants utilized a cuffed 7.0 or 7.5 endotra-
cheal tube and could use a flexible stylet, rigid stylet, or bougie
based on personal preference. The medics were in the simula-
tion trainer which was pulled behind a vehicle at 15–25 miles
per hour to simulate movement of flight (supplemental Figure
1, supplemental Figure 2, supplemental Figure 3). Participants
were given a verbal patient care scenario involving manage-
ment of an urgent, wounded casualty requiring various inter-
ventions but culminating in the indication to intubate. Time
started when the participant touched the SynDaver as part of
the ETI procedure, and time was stopped when they indicated success or failure. We defined success as the endotracheal tube
the procedure was complete. The proctor for the simulation inserted into the trachea to an appropriate depth. We recorded
would provide verbal prompts as the participants progressed every time they inserted and removed the endotracheal tube
on when the airway indication was present and changes in from the oral cavity as an attempt. Participants evaluated
vital signs as the time elapsed. An emergency medicine board- their view of airway anatomy utilizing the Cormack-Lehane
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certified physician team member assessed the intubation as grading system. After completing the procedure, participants
Helicopter Simulation Video Laryngoscope | 27