Comparison of malleable stylet and reusable and disposable bougies by paramedics in a simulated difficult intubation

Abstract

SummaryIn a randomised crossover study, 60 ambulance paramedics attempted tracheal intubation of a manikin model of a Cormack and Lehane grade 3 ⁄ 4 view using a Portex stylet, Portex and Frova single-use bougies, and a Portex reusable bougie. Tracheal intubation within 30 s was achieved by 34 ⁄ 60 (57%) using the stylet, 18 ⁄ 60 (30%) using a Portex single-use bougie, 16 ⁄ 60 (27%) using a Frova single-use bougie and 5 ⁄ 60 (8%) using a Portex reusable bougie.

A randomised crossover comparison of two endotracheal tube introducers: the FROVA and the Flexible Tip Bougie for GlideScope intubation of a difficult airway manikin by infrequent intubators

“…Sharma outlined the limitations of GlideScope "intubation" as opposed to "laryngoscopy", suggesting that the two should be considered separately [19]. Previous comparative manikin studies include laryngoscopy time, measuring the time the blade enters the mouth until the ETT is fully inserted [12,16,20]. By excluding laryngoscopy and providing a static, constant view of the larynx, we provided the same view for each participant in both arms of the crossover study.…”

Comparing Performance of Video and Direct Laryngoscopes for Urgent Endotracheal Intubation

“…It is recommended that when speed of endotracheal intubation is important (as in a patient undergoing cardiopulmonary resuscitation), an endotracheal tube should always be equipped with a stylet. In a randomized crossover study, Gregory et al (4) found that when the endotracheal intubation was performed by ambulance paramedics in a manikin of Cormack-Lehane grade 3 or 4 laryngoscopic view, the malleable stylet facilitated the highest intubation success rate with the shortest breathto-breath interval when compared with the Frova single-use bougie, Portex reusable bougie, and Portex single-use bougie.…”

Efficacy of tracheal tube introducers and stylets for endotracheal intubation in the prehospital setting: a systematic review and meta-analysis

“…The nine remaining studies had their reference lists screened and a further four studies were identified and included. A total of 13 studies were therefore included in our qualitative synthesis [14][15][16][17][18][19][20][21][22][23][24][25][26]. Of these studies, 10 were included in our quantitative synthesis [14,15,[19][20][21][22][23][24][25][26].…”

“…A total of 13 studies were therefore included in our qualitative synthesis [14][15][16][17][18][19][20][21][22][23][24][25][26]. Of these studies, 10 were included in our quantitative synthesis [14,15,[19][20][21][22][23][24][25][26]. This study selection process has been summarised in a PRISMA flow chart (Fig.…”

“…Every study had at least 7% of criteria answered "CD/NA/NR" as every study investigated an exposure that could not vary in amount or level. Eight studies had 14% of criteria answered "CD/NA/ NR" [17][18][19][22][23][24][25][26] as it could not be determined whether the participation rate of eligible persons was at least 50%.…”