Please select the eligibility criteria that correspond to the clinical trial below.
Title: Randomized Controlled Trial to Evaluate the Efficacy of Video-laryngoscopy vs. Direct Laryngoscopy for Endotracheal Intubation in the Critically Ill Patients: A Pilot Study
Brief Summary: Endotracheal Intubation (ETI) is done to place a plastic tube in a patient's trachea (windpipe) to assist with breathing. Patients admitted to the intensive care unit (ICU) are the sickest of patients and the majority of them require this life saving procedure. A critical illness can be sudden and ETI required urgently. The doctors performing ETI in these situations may not be experts at ETI. Studies have shown that if it takes more than one attempt to get the tube in the right position patients can have severe complications such as: decrease level of oxygen in the body, decrease blood pressure, and cardiac arrest. These complications can be life threatening and increase the length of time spent in an ICU.

To perform ETI the doctor uses a metal tool called a laryngoscope that is placed through the patient's mouth to open the throat and then pass the tube into the trachea. The type of procedure that has been used for many years is called Direct Laryngoscopy (DL) which means that the doctor looks through the mouth directly into the throat. Newer technology is available and can be used at VGH called Video Laryngoscopy (VL). With VL there is a camera on the end of the laryngoscope and a video image is displayed on a monitor making it easier to see the entrance to the trachea. VL is not available for all cases at VGH and is unavailable in many other hospitals.

In this study we will compare DL to VL. Patients will be randomly placed in one of two groups: first attempt at ETI done with DL or first attempt of ETI done with DL. Patients will only be considered eligible for this study if the doctor feels that either DL or VL would be appropriate for the patient. In this pilot study we hope show that conducting a larger study would be feasible. If a larger study were to show that VL decreases complications and shortens length of ICU stay we would be able to recommend this procedure for all ETI at VGH as well as other hospitals where it currently may not be available.


Options:
A: Inclusion Criteria:

The patients who will undergo general anesthesia for abdominal surgery, American Society of Anesthesiologists physical status I to III, The patients who were aged between 20 and 75

Exclusion Criteria:

Our exclusion criteria were to have a history of emergency intubation or a difficult intubation, to have a body mass index higher than 35 or a rheumatologic disease that cause limitation of cervical motion, to have a previous history of cervical operation or tumor, trauma or infection on upper airway, and to have no tooth.
B: Inclusion Criteria:

* Any patient who is ≥ 18 yrs. coming for elective surgery.
* Endotracheal tube is indicated for the procedure in the opinion of the attending anesthesiologist.
* Any operator who has performed ≥ 10 GlideScope intubations.

Exclusion Criteria:

* Any patient in whom the use of the GlideScope is contraindicated in the opinion of the attending anesthesiologist.
* Any patient with cervical spine abnormalities.
* Any patients with known or probable difficult airways (this rare occurrence is unlikely to be evenly distributed between the groups and could skew the data).
* Any patient requiring rapid sequence induction.
C: Inclusion Criteria:

* Adults (18 years and over) scheduled for elective surgery whose anaesthetic plan would normally include oral intubation using a Macintosh laryngoscope blade after induction of general anaesthesia and who have given valid informed consent.

Exclusion Criteria:

* Patients requiring special techniques for intubation such as rapid sequence induction
* Adults who have learning difficulties
* Are unconscious or very severely ill
* Have a terminal illness; are in an emergency situation
* Have a mental illness
* Have dementia
* Prisoners
* Those who could be considered to have a particularly dependent relationship with the investigator and other vulnerable groups.
D: Inclusion Criteria:

* Any patient over the age of 16 years, requiring urgent (within 30 minutes) endotracheal intubation, who are attended to by the critical care team will be eligible for enrolment

Exclusion Criteria:

* Patients who require intubation within 5 minutes or have contraindications to either of the study intubation technique will be ineligible
* cardiac arrest
* cardiopulmonary instability (oxygen saturation \<90% or systolic blood pressure \< 80 mmHg despite oxygen or fluid therapy)
* any clinical deterioration while awaiting randomization
* known prior or anticipated difficult intubation
* need for awake intubation (defined by sedation, topicalization and avoidance of neuromuscular blockade)
* pregnancy
* cervical spine precautions
* any patient deemed inappropriate for enrolment by the attending physician

Answer: D