A comparison of the forces applied to maxillary incisive theeth during laryngoscopy with different laryngoscopes

Soft tissue and dental trauma may be observed during emergency department intubation of critically ill patients. Video laryngoscopes are assumed to cause less airway trauma during airway management. The aim of this manikin study is to compare force exerted to maxillary teeth with different laryngoscopes during intubation in easy and difficult airway scenarios. A total of 45 ED residents from different PGYs attempted orotracheal intubation with 3 different laryngoscopes and six different blades in normal and difficult (cervical immobilized) airway scenarios. Devices are randomized to each participant. The forces exerted to maxillary incisors in ascending order were McGrath MAC #3 and X blade, then Glidescope and CMAC-d and the forces applied on maxillary teeth was higher with CMAC and Macintosh Laryngoscope. Our results suggest that, the shape of the blade and to a lesser extent the video camera applied to laryngoscope seems to decrease the force applied to maxillary incisors.