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ACADEMIC EMERGENCY MEDICINE September 1998. Volume 5, Number 9 919 Assessment of Airway Visualization: Validation of the Percentage of Glottic Opening (POGO) Scale RICHARD M. LEVITAN, MD, E. ANDREW OCHROCH,MD, S C O W KUSH, MPH, FRANCES S. SHOFER,PHD, JUDD E. HOLLANDER,MD Abstract. Objective: Research defining optimal methods of intubation has been limited by the lack of a validated outcome measure to assess airway visualization. The objective of this study was to develop a reliable scale for the assessment of airway visualization during endotracheal intubation. Methods: This prospective study was performed to assess the intra- and interphysician reliabilities of emergency physicians (EPs) for estimating the percentage of glottic opening (POGO) that is visualized during direct laryngoscopy. Using video images of laryngeal views obtained from a commercially available videotape, still slide images were prepared representing glottic openings ranging from 0% to 100%. Five EPs, blinded to study objective, reviewed 25 pairs of airway slides (50 slides total). For each slide, the physicians recorded the POGO and their scores using a modified Cormack-Lehane (MCL) scale, where grade I is a view of the full glottic opening, MCL grade I1 is a partial view of the glottic opening, and MCL grade III is a view of the epiglottis only. Inter- and D IRECT laryngoscopy for the purpose of endotracheal intubation is a critical resuscitation skill and fundamental to the practice of emergency ...
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