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document
Cervical spine motion : a fluoroscopic comparison during intubation with lighted stylet , GlideScope , and Macintosh laryngoscope . The question of which is the optimum technique to intubate the trachea in a patient who may have a cervical ( C ) -spine injury remains unresolved . We compared , using fluoroscopic video , C-spine motion during intubation for Macintosh 3 blade , GlideScope , and Intubating Lighted Stylet , popularly known as the Lightwand or Trachlight . Thirty-six healthy patients were randomized to participate in a crossover trial of either Lightwand or GlideScope to Macintosh laryngoscopy , with in-line stabilization . C-spine motion was examined at the Occiput-C1 junction , C1-2 junction , C2-5 motion segment , and C5-thoracic motion segment during manual ventilation via bag-mask , laryngoscopy , and intubation . Time to intubate was also measured . C-spine motion during bag-mask ventilation was 82 % less at the four motion segments studied than during Macintosh laryngoscopy ( P < 0.001 ) . C-spine motion using the Lightwand was less than during Macintosh laryngoscopy , averaging 57 % less at the four motion segments studied ( P < 0.03 ) . There was no significant difference in time to intubate between the Lightwand and the Macintosh blade . C-spine motion was reduced 50 % at the C2-5 segment using the GlideScope ( P < 0.04 ) but unchanged at the other segments . Laryngoscopy with GlideScope took 62 % longer than with the Macintosh blade ( P < 0.01 ) . Thus , the Lightwand ( Intubating Lighted Stylet ) is associated with reduced C-spine movement during endotracheal intubation compared with the Macintosh laryngoscope .
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Intervention_Surgical
Lightwand
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Intervention_Physical
or
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Intervention_Surgical
GlideScope
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Intervention_Physical
to
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Intervention_Surgical
Macintosh laryngoscopy
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Intervention_Physical
, with
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Intervention_Surgical
in-line stabilization
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Intervention_Physical
manual ventilation via bag-mask ,
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Intervention_Surgical
laryngoscopy
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Intervention_Physical
, and
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Intervention_Surgical
intubation
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Outcome_Physical
C-spine motion
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Outcome_Physical
C-spine motion
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Outcome_Other
Time
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Outcome_Physical
C-spine motion during bag-mask ventilation
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Outcome_Physical
C-spine motion using the Lightwand
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Outcome_Other
time to intubate
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Outcome_Physical
C-spine motion
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Outcome_Other
longer
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Outcome_Physical
C-spine movement