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Laryngoscopic evaluation with the Airway Cam® laryngoscopy video system

[Évaluation laryngoscopique avec le système de laryngoscopie vidéo Airway Cam®]

From the Department of Anesthesia, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada.

Address correspondence to: Dr. Ronald B. George, Department of Anesthesia, Room 5452 Halifax Infirmary, QE II Health Sciences Centre, 1796 Summer Street, Halifax, Nova Scotia B3H 3A7, Canada. Phone: 902-473-2325; Fax: 902-473-9454; E-mail: rbgeorge{at}eastlink.ca

Purpose: The Airway Cam® is a head-mounted direct laryngoscopy video system which uses a prismatic sighting system that aligns with the operator’s line of sight. This study evaluated intra- and inter-observer consistency in laryngoscopy grading comparing direct laryngoscopy to the laryngoscopy grade obtained with the Airway Cam®.

Methods: Twenty-seven patients receiving a general anesthetic for elective surgery had laryngoscopy performed by an anesthesiologist wearing the Airway Cam®. Each video was duplicated, then randomized and reviewed in a blinded fashion by the original laryngoscopist and a second anesthesiologist. Intra- and inter-observer correlations were identified.

Results: There was good intra-observer agreement of the Cormack-Lehane scale between direct laryngoscopy and laryngoscopy recorded with the Airway Cam® ( = 0.63). The corresponding intra-observer correlation of the percentage of glottic opening score was strong at r = 0.83. There was good inter-observer agreement of the Cormack-Lehane scale between direct laryngoscopy and that observed by the second anesthesiologist during Airway Cam® video review ( = 0.70). There was moderate correlation of the inter-observer percentage of glottic opening scores (r = 0.73).

Conclusion: This study validates that the view recorded by the Airway Cam® reflects the view of the laryngoscopist. The Airway Cam® may introduce an additional level of objectivity into airway management research and teaching.