Comparison of intubation performance by emergency medicine residents using gum elastic bougie versus standard stylet in simulated easy and difficult intubation scenarios. (26th August 2014)

• Record Type: Journal Article
• Authors: Walsh, Ryan; Cookman, Laura; Luerssen, Emily
• Is Part Of: Emergency medicine Australasia. Volume 26:Number 5(2014)
• Page Start: 446
• Page End: 449
• Publication Date: 2014-08-26
• Subjects: Emergency medicine -- Periodicals; Emergency medicine -- Australasia -- Periodicals; 616.025
• DOI: 10.1111/1742-6723.12280
• Languages: English
• ISSNs: 1742-6731

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="emm12280-sec-0001" sec-type="section"> <title>Objective</title> <p>We sought to evaluate the success rate and time to endotracheal intubation by emergency medicine residents with stylet reinforced endotracheal tube (ETT‐S) versus intubation with a gum elastic bougie (GEB) in simulated easy and difficult airways on a cadaveric model.</p> </sec> <sec id="emm12280-sec-0002" sec-type="section"> <title>Methods</title> <p>The study was a prospective cross‐over design using a cohort of 29 emergency medicine residents. A fresh frozen cadaver was used in either standard positioning to facilitate a Cormack Lehane Grade 1 laryngoscopy, or with a hard cervical collar applied a Cormack Lehane Grade 3 laryngoscopy. Each participant then intubated the cadaver in each setting. The primary end‐point of our investigation was the time to intubation. Secondary end‐points were: success rate of intubation, mean ratings by study participants of perceived ease of intubation for each intubation technique in each simulated degree of difficulty, and overall preference of intubation technique in each simulated degree of difficulty.</p> </sec> <sec id="emm12280-sec-0003" sec-type="section"> <title>Results</title> <p>Mean time to intubation in all scenarios ranged from 28.8–116.6 s. Time to intubation was significantly different only when comparing Grade 3 ETT‐S to Grade 3 GEB. There was no significant difference in success rate when comparing Grade 1 ETT‐S to Grade 1 GEB (<italic>P</italic> = 0.99) nor Grade 3 ETT‐S to Grade 3 GEB (<italic>P</italic> = 0.21).</p> </sec> <sec id="emm12280-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Time to intubation in a simulated grade 3 view was significantly longer in the GEB group versus the ETT‐S group. Although the differences in success rates were not statistically significant, there was a trend toward more successful intubations with the GEB in the simulated grade 3 view.</p> </sec> </abstract>