Implementing videolaryngoscopy in anaesthetist-staffed pre-hospital critical care

Background Pre-hospital endotracheal intubation may be challenging, even in expert hands [1,2]. Difficult or failed endotracheal intubations are associated with complications that can be life threatening [1] and the risk of complications increases when the first endotracheal intubation attempt is not successful [2]. The McGRATH MAC videolaryngoscope may have the potential to improve first-pass success rates [3] and reduce complication rates and we therefore introduced this as the standard primary device for endotracheal intubation in our anaesthetist-staffed pre-hospital critical care services. As part of the quality insurance program, we investigated the attending anaesthetists’ adherence to this new standard and their reasons for non-adherence.