On the basis of the results of this study, we conclude that, compared with direct laryngoscopy, video laryngoscopy does not improve intubation outcomes in emergency and critical patients. Prehospital intubation is even worsened by use of video laryngoscopy when performed by experienced operators.

67 studies were selected for full-text assessment using our inclusion and exclusion criteria.

12 studies (2,583 patients) were included in the review for data extraction.

Only randomized controlled trials comparing video and direct laryngoscopy for tracheal intubation in emergency department, intensive care unit, and prehospital settings were selected.

Pooled analysis did not show an improved first-attempt success rate using video laryngoscopy.

There was significant heterogeneity among studies.

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