Abstract Introduction: Adequate and continuous airway management by health professionals is fundamental to ensure patient safety and protection. Among several techniques, laryngoscopy for orotracheal intubation is considered a basic skill, so it is taught and learned in medical school and used during the future years of professional practice. However, in some clinical scenarios, physical and anatomical characteristics can make laryngoscopy exceedingly difficult. In the last decade, some new devices have emerged to apply indirect or video-assisted imaging systems, so-called videolaryngoscopes. They have shown great efficiency in difficult intubation cases and have improved teaching and training. Our study introduced a videolaryngoscope, the McGrathTM MAC, in the regular laryngoscopy training rotation for 3rd-year undergraduate medical students and evaluated whether there was any associated optimization of the students’ performance. Method: Students from two different classes and years (2017 and 2018) were randomly divided into two groups and received theoretical and practical training in the techniques of Direct Laryngoscopy (DL) and Videolaryngoscopy (VL). The students in each group applied the manoeuvres and simulated three tracheal intubation attempts on mannequins. They were evaluated for their success rate on the first attempt, the time required to finalize the intubation, and the visualization of the glottic structures according to the classification of Cormack-Lehane (C&L). Results: Two hundred and four students with an average age of 21 ± 2 years participated in the study; the groups were similar. There was a significant difference between the VL and DL groups in the 1st attempt success rate (97% and 89.4%, respectively, p = 0.0497 - 95% CI), but such a difference was not seen for the other attempts or regarding the number of oesophageal intubations (3% and 7.7%). The students in the VL group were faster than those in the DL group in all intubation attempts; in parallel, the vast majority of the VL group reported excellent visualization conditions, with 75% of the attempts classified as Cormack-Lehane grade 1. Conclusion: The introduction of a videolaryngoscope in medical students’ training improved the visualization of anatomical structures and allowed tracheal intubation maneuvers to be performed faster and with a higher success rate on the first attempt. Thus, under the conditions of this prospective study, the videolaryngoscope had a positive impact on training and proved to be a promising tool for teaching laryngoscopy.

JUSTIFICATIVA E OBJETIVOS: O látex, (cis 1,4 polyisoprene) está muito presente no dia-a-dia do anestesiologista. Os primeiros relatos de alergia ao látex datam de 1933. A sensibilidade ao látex na população de anestesiologistas é de 12,5% a 15,8%. A incidência de sensibilidade ao látex aumenta muito em grupos específicos, podendo produzir reações graves e até mesmo fatais. O objetivo desse estudo foi realizar uma revisão bibliográfica sobre o assunto, abordando este tema de interesse para o anestesiologista, considerando diagnóstico, prevenção e tratamento da alergia ao látex. CONTEÚDO: Os estudos sobre a prevalência das reações alérgicas ao látex variam muito conforme a população estudada e os métodos utilizados para estabelecer a sensibilidade ao antígeno. Mesmo com estas variações, existem alguns grupos em que o risco é elevado, particularmente em pacientes com distúrbio na formação do tubo neural. As manifestações clínicas variam desde dermatite de contato até anafilaxia e óbito. O diagnóstico precoce com pesquisa de IgE pode prevenir as reações de hipersensibilidade. CONCLUSÕES: É de extrema importância o diagnóstico precoce da alergia ao látex. A abordagem desses pacientes em ambientes livres de látex evitam a sensibilização e evolução muitas vezes para quadros dramáticos.

BACKGROUND AND OBJECTIVES: Latex products very present in the Anesthesiology practice. The first latex allergy report dates from 1933. The incidence of latex sensitivity among anesthesiologists is 12.5% to 15.8%. It increases in some specific groups leading to dangerous reactions and even to lethal cases. The purpose of this study was to review literature on such important subject to the anesthesiologist, addressing diagnosis, prevention, and treatment of latex allergy. CONTENTS: Studies on the prevalence of latex allergy differ a lot because different populations are evaluated with different methods to establish the sensitivity to the antigen. In spite of those variations there are some very high-risk groups, especially disabled children with neural tube defects. Clinical presentations vary from cutaneous eruptions to anaphylaxis and death. Early diagnosis with IgE evaluation may prevent such reactions. CONCLUSIONS: The early diagnosis of latex allergy is critically important. Dealing with these patients in latex-free environments prevents sensitization and, very often, the evolution to dramatic situations.

JUSTIFICATIVA Y OBJETIVOS: El látex, (cis 1,4 polyisoprene) está muy presente en el dia-a-dia del anestesista. Los primeros relatos de alergia al látex se originan desde 1933. La sensibilidad al látex en la población de médicos anestesistas es de 12,5 a 15,8%. La incidencia de sensibilidad al látex aumenta mucho en grupos específicos, pudiendo producir reacciones graves y también fatales. El objetivo de ese estudio fue realizar una revisión bibliográfica sobre el asunto, abordando este tema de interés para el anestesista, considerando diagnóstico, prevención y tratamiento de la alergia al látex. CONTENIDO: Los estudios sobre la prevalencia de las reacciones alérgicas al látex varían mucho conforme la población estudiada y los métodos utilizados para establecer la sensibilidad al antígeno. Mismo con estas variaciones, existen algunos grupos en que el riesgo es elevado, particularmente en pacientes con disturbio en la formación del tubo neural. Las manifestaciones clínicas varían desde dermatitis de contacto hasta anafilaxia y óbito. El diagnóstico precoz con pesquisa de IgE puede prevenir las reacciones de hipersensibilidad. CONCLUSIONES: Es de extrema importancia el diagnóstico precoz de la alergia al látex. El abordaje de eses pacientes en ambientes libres de látex evitan la sensibilización y evolución muchas veces para cuadros dramáticos.