The main reasons for failed TI attempts with the McGrathVL were the impossibility to advance the tube into the larynx or trachea, or disturbances caused by ambient light, which was highly significant in trauma patients (in 13.5% of DL patients vs 73.3% of VL patients).
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Comparing the McGrath Mac Video Laryngoscope and Direct Laryngoscopy for Prehospital Emergency Intubation in Air Rescue Patients: A Multicenter, Randomized, Controlled Trial.
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This did not reach statistical significance, but the subgroups were too small to draw a meaningful conclusion.