Critical Appraisal to Glide Scope Video Laryngoscope - Research Proposal Example

Critical Appraisal to GlideScope video laryngoscope” Critical Appraisal to GlideScope video Laryngoscope Introduction: The evaluation of study regarding the subject of laryngoscopy is significant because its practice has raised the question of laryngoscopic view by usage of different devices such as Macintosh devices, GlideScope etc. Many medical professionals have shown interest in knowing the usage of suitable device to undergo a successful laryngoscopy. Some of the medical professionals have highlighted the convenience of GlideScope because it allows the view of glottis with the usage of a camera. This enables surgeons to avoid the oral usage of alignment and tracheal axes. It is for this reason that many practice-based researches have been conducted. This paper makes use of a chosen research i.e. GlideScope video laryngoscope: a randomized clinical trial in 203 paediatric patients. This will allow understanding with different devices used for laryngoscopy. Research Strategy: In order to find the most relevant and effectively conducted research, it was necessary to research through scholarly sources available on the published journal article databases (Greenhalgh 2010). The research topic that was focused for the research was comparable laryngoscopic views. The significant research databases that were researched were Pub Med= 6 hits and CINHAL=4 hits. The keywords that were used to find out the relevant research included GlideScope, anaesthesia, and paediatric laryngoscopy. Also, while researching, it was also necessary to make use of recent and advanced informative article. It is for this reason that the years of research in the database were made limited to 2005 to 2011. The basic strategy appointed for the research was to skim articles that were published in English language and limited to paediatrics laryngoscopy. Introduction: A number of researches have been conducted to compare the view of laryngoscopy under different airway situation. The article GlideScope Video Laryngoscope: A Randomized Clinical Trial in 203 paediatric patients written by Kim et al., (2008), is in-depth address to the quality of GlideScope to provide a superior laryngoscopic view. The purpose of addressing the quality of the GlideScope is to evaluate the comparative direct view of laryngoscopy in adults. This article also takes the time of intubation as a purpose of study (Kim et al. 2008). However, it has been noted that the topic of the research does not cover the actual objective of the research. The usage of keyword such as comparison or Macintosh device for laryngoscope should have been used to make the article give the clear essence of the objective (Yentis and Smith 2009). The study conducted by Kim et al. (2008) is an in-depth address to the quality of GlideScope to provide a superior laryngoscopic view. The purpose of addressing the quality of the GlideScope is to evaluate the comparative direct view of laryngoscopy in adults. This article also takes the time of intubation as a purpose of study (Kim et al. 2008). The initial research has been conducted with clear indicative information that gives an idea to the readers regarding the research motives. The research under review can also be regarded as a fruitful yet interesting research. It is because a number of models have been used to provide accuracy to the overall study. First and foremost the research under review has a comprehensive abstract. Research specialists have made it evident that an abstract must provide clear indication about the method that has been appointed for the research. An abstract should also give slight idea about the conclusion. However, the objective of the research should be made very clear in the abstract. Kim et al. have carefully used the characteristics of the abstract and discussed the objective in a very comprehensive manner. But the word count (200+) of abstract exceeded from the standard figure of 150. An introduction to the study is considered as a very imperative section which provides a brief introduction to the phenomenon and concepts to be studied within the context of the study. The introductory paragraph of the article allows the readers to build understanding with the problem statement that has been undertaken by the authors. The introduction of the article under review clearly sets the problem statement to understand the provide appreciation to one device for better laryngoscopic view. However, it has been noted that the hypothesis has not been set out in the introductory paragraph. The hypothesis is clear from the abstract but it should have been added I the introductory paragraph as well. One of the problematic aspects of Kim et al., research is a lack of literature review. The authors have not allowed the basic definition of the concepts and models used in the research and analysis section of the article. It should be noted that it is highly significant to add literature review to the research. This allows general audience to make use of the article as a reference as well. It should be noted that the authors are professionals and have clear understanding of the concepts and phenomenon. It is being assumed that the lack of literature is mainly due to limited word count required by the journal articles. This problem has added limitation to the research. The accuracy of the research has become less understandable for general audience because of lack of literature review. The method section of a research article can be very helpful for authors to communicate develop thorough structure to their research. The research by Kim et al. has been conducted with ethical consent taken from the hospitals. The research methodology chosen by the authors gathers data from assessment of 203 children. The sample is very large in comparison with the studies that have been conducted in the same field of subject matter. The research is also ethically correct because the consent was taken from the parents, medical practitioners in renowned hospitals and guardians. The authors have also made use of chosen criteria to select the participants (Simpson and Popat 2002). Children aged from 3 months to 17 years were selected for the research survey. These research criteria excluded participants with likelihood of pulmonary aspiration and increased intracranial pressure. The authors had an informed background the research and it was because of this reason that special consideration was given to neck extension as noted with the help of Mallampatti classification. The usage of this criterion has enabled the authors to actually come up with accuracy of results (Pletcher, Kertesz and Kohn 2008). It should be noted that the allocation of participants is a very significant aspect of a research. This allows the researchers to skim results in the most effective way. This research has accurate measures of allocation of research. Computer-generated randomization has been used in the paper. The two distinctive groups as selected in this research include the laryngoscopy by Macintosh bladed Welch while the second group is laryngoscopy by GlideScope. The first group was named as DL group while the second group was named as GS group. BURP manoeuvre was also used in order to ease out the intubation process. It is considered as the harmless way to ease the pressure on mouth and help professionals get done with the intubation process (Karsli, Armstrong and John 2010). There have been a number of researches that were conducted previously but they lacked accuracy because of the models used for the allocation of participants into different groups (Leaper and Whitaker 2010). In this regard, this research has made its mark as it can be implied for its accurate results. Likewise, in other researches, the error ratio has remained same but despite their respective criterion, accurate measures could not be found (Lim, Lim and Liu 2005). It was because of the pre-medication of the participants. In the research under review, this problem has been given special consideration. Participants for the research survey were not given medication for prior week (Gwinnutt 2008). Anaesthetic process needs careful measurements of oxygen and application (Fleisher 2009). In this regard, the authors have enabled the monitoring in the operation theatre with careful application of models such as electrocardiography, non-invasive, arterial pressure, pulse oximetry etc. Model of anaesthesia was provided after careful monitoring in an operation theatre. It should also be noted that the authors have conducted analysis of operation (actual experimentation) as lungs were also ventilated. The ventilation was done with the usage of 4-8% volume of sevoflurane in oxygen through facemask (Choi, et al. 2011). The findings and analysis section of the research should be explained briefly so that the readers can get knowledge of analysis models. Also, the research method becomes credible when the findings and analysis section allows accurate conclusion. It has been noted Kim et al. have made use of effective analysis techniques and found out that that GlideScope allowed equal or better laryngoscopic view. The results were based upon the view of different patients by using both GlideScope and Macintosh devices (Drummond 2011). Also, difference was also noted in terms of BURP application to ease out the intubation process. The section of findings and analysis has relatively better way of illustrative findings than any other article regarding the chosen subject matter. Even the slightest information has been discussed in the analysis part which allows this section to be much more approached and comprehensive. The discussion section has also been backed up with analysis (Elliott and Smith 2010). Overall, it could be said that the application and reference of the article is possible because it has allowed a large survey sample. However, it has been noted that there are some sections that are not provided in the article. It should have been better if the authors would have allowed the readers to get aware regarding the literature reviewed to undergo the study (British National Formulary 2010). Practical Implication: The conclusion of the research under review makes it easier to understand as to why the usage of GlideScope can be difficult in some cases. However, its use provides better view but it has been noted that it is time consuming. The view by GlideScope among children was quiet difficult because of the angle of 60 degrees (McCaughey 1997). There were several attempts that were needed to make in order to get the clear view through GlideScope. This makes it evident that in order to undergo time-effective and cost-effective laryngoscopy then it is significant to make use of direct view devices. Medical professionals will not need to repeat the attempts to get the blades fixed (Institute NHS 2011). The research also suggests that in order to conduct a safe and effective laryngoscopy, it is suggested that BURP manoeuvre is used. Intubation can become very easy by using BURP manoeuvre in the laryngoscopy by Macintosh device or GlideScope (Park and Serrano 2003). Medical professionals must used any of the two devices discussed above to conduct laryngoscopy provided the manufacture details have been taken into consideration i.e. the sized of blades and stretch of mouth to certain centimetres. This means that hospitals must include access to GlideScope so that medical professionals can select the device depending upon the case and their adherence to the usage of device. It has often been noted that some of the hospitals do not provide access to GlideScope because of its cost (Phipps 2008). Ethical Consideration: As per the guiding principles for ethical consideration in the medical field, it should be noted that the research to be conducted must provide knowledgeable ground to the audience relevant to field of subject matter. Considering this ethical principle, it can be said that this article has provided a through understanding with the experimentation procedure. It also provides appreciation regarding GlideScope to be used by the medical professionals undertaking surgeries to obtain better laryngoscopic view (McLean and Mason 2009). Another ethical principle is that the survey participants must be provided security of confidentiality and should be free from all type of physical harm. This pointer has been carefully followed by the authors in the experimentation. It can be seen that the patients were not given any medication before the operation. Anaesthesia was carefully balanced out within the oxygen transfer. The research has carefully made notice of the confidentiality of the participants. Justice can also be marked as a very important aspect of the ethical grounds to be followed by researchers (Hagberg 2007). According to this principle, authors must provide equal treatment to all participants. Kim et al. has carefully used two methods for conducted laryngoscopy. However, the two operation techniques are different but they have similar outcome. The only difference was the view of laryngoscopy for medical professionals who conducted the operation. It should also be noted that the medical professionals who undertaken the experimentation were professionals and had an experience with laryngoscopy (Kim et al. 2008). List of References British National Formulary, 2010. British Medical Association and the Pharmaceutical Press. [Online] Available at: [Accessed 27 February 2012]. Choi, G., Lee, E., Lim, C. and Yoon, S., 2011. A comparative study on the usefulness of the GlideScope or Macintosh laryngoscope when intubating normal airways. Korean J Anesthesiol, 60(5), pp.339-43. Drummond, K.E., 2011. Minimally invasive cardiac output monitors. [Online] Available at: [Accessed 27 February 2012]. Elliott, A. and Smith, S., 2010. Handbook of Acute Pain Management. London: Informa Healthcare. Fleisher, A., 2009. Evidence-based practice of anaesthesiology: Expert consultant 2nd ed. Philadelphia: Saunders. Greenhalgh, T., 2010. How to read a paper: The basis of evidence based medicine 4th ed. London: BMJ Books. Gwinnutt, L., 2008. Lecture Notes on Clinical Anaesthesia 3rd Edition. Oxford: Blackwell Publishing. Hagberg, A., 2007. Benumof’s Airway Management 2nd ed. St Louis: Mosby – Year Book. Institute NHS, 2011. Institute for innovation and improvement Enhanced recovery Programme. [Online] Available at: [Accessed 27 February 2012]. Karsli, C., Armstrong, J. and John, J., 2010. A comparison between the GlideScope Laryngoscope and direct laryngoscope in paediatric patients with difficult airways – a pilot study. Anaesthesia, 65, p.353–357. Kim, J. et al., 2008. GlideScope video laryngoscope: a randomized clinical trial in 203 paediatric patients. British Journal of Anaesthesia, 101(4), p.531–4. Leaper, J. and Whitaker, I., 2010. Oxford Specialist Handbooks: Handbook of Postoperative Complications 2nd ed. Oxford: Oxford University Press. Lim, T., Lim, Y. and Liu, C., 2005. Evaluation of ease of intubation with the GlideScope Macintosh laryngoscope by anaesthetists in simulated easy and difficult laryngoscopy. Anaesthesia, 60, pp.180-83. McCaughey, W., 1997. Anaesthetic Physiology and Pharmacology. New York: Churchill Livingstone. McLean, M. and Mason, K., 2009. Legal and ethical aspects of healthcare. Cambridge: Cambridge University Press. Park, R. and Serrano, G., 2003. Key Facts in Anaesthesia and Intensive Care 3rd ed. London. London: Greenwich Medical Media. Phipps, D., 2008. Human factors in anaesthetic practice: insights from a task analysis. > [Accessed: 11 January 12]. [Online] Available at: [Accessed 27 February 2012]. Pletcher, M., Kertesz, S. and Kohn, M., 2008. Trends in Opioid Prescribing by Race/Ethnicity for Patients Seeking Care in US Emergency Departments. The Journal of American Medical Association, 299(1), pp.71-78. Simpson, J. and Popat, T., 2002. Understanding Anaesthesia 4th ed. Oxford: Butterworth Heinemann. Yentis, S. and Smith, G., 2009. Anaesthesia and Intensive Care A to Z: an encyclopaedia of principles and practice 4th ed. New York: Elsevier. Read More