(A217) Evaluating Glidescope® Injuries: A Case Series of 16 Patients and Technical Considerations

Introduction: Video laryngoscopy has increasingly become the preferred method of visualization in intubation performed by anesthesiologists when managing difficult airways. This single-institution study describes 16 Glidescope-related intubation injuries. Data collected included patient demographics, procedural details, and injury classifications.

Methods: This retrospective case series examines patients who sustained intubation trauma when a Glidescope video laryngoscopy system was utilized at our tertiary care hospital or ambulatory surgery centers between June 2014 and August 2023. Fisher's exact test and independent t-tests/ Mann-Whitney U tests were used for statistical analysis of categorical and continuous variables, respectively. Injury severity, determined by the need for surgical repair, was used to assess associations with patient- and procedure-related factors.

Results: Injuries were primarily located in the oropharynx (n=8) and soft palate (n=15), with subgroups including the anterior tonsillar pillars (n=3), posterior pharyngeal wall (n=3), and uvula (n=3), with lacerations being the most common injury (n=10). Intubations were performed by certified registered nurse anesthetists (CRNA) and physicians. All intubation injuries associated with the need for surgical intervention were performed by a CRNA. No specific trends were observed when evaluating patient demographics including age, number of intubation attempts, history of radiation, kyphosis or limited cervical extension, trismus, Mallampati score, structural abnormalities, or tonsillar hypertrophy.

Conclusions: This case series highlights the absence of significant patient or provider-related commonalities associated with Glidescope ® injuries. The lack of identifiable risk factors in Glidescope injuries drives home the importance of proper intubation techniques, including direct visualization when passing the ET tube into and through the oropharynx rather than focusing on the video screen alone, to reduce soft tissue injuries in the oral cavity and pharynx.