Effect of the use of a video laryngoscope and bougie on the performance of endotracheal intubation on the ground by novice prehospital caregivers: a randomized simulation study

Song, Hyung Woo; Kang, Gu Hyun; Jang, Yong Soo; Kim, Wonhee; Choi, Hyun Young; Kim, Jae Guk; Lee, Yoonje; Kim, Tae Yong; Bang, Sung Hwan

J Korean Soc Emerg Med > Volume 32(4); 2021 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2021;32(4): 362-370.

119 대원에 의하여 지면 위 자세에서 이루어지는 기관내 삽관에서 비디오 후두경과 부지의 사용이 가지는 효과: 무작위 시뮬레이션 연구

송형우¹

¹한림대학교 강남성심병원 응급의학과
²대전보건대학교 특전의무부사관과

Effect of the use of a video laryngoscope and bougie on the performance of endotracheal intubation on the ground by novice prehospital caregivers: a randomized simulation study

¹Department of Emergency Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
²Department of Non-commissioned Special Officer Academies, Daejeon Health Institute of Technology, Daejeon, Korea

Correspondence

Gu Hyun Kang ,Tel: 02-829-5119, Fax: 02-842-4217, Email: drkang9@gmail.com,

Received: June 29, 2020; Revised: August 31, 2020 Accepted: September 25, 2020. Published online: August 31, 2021.

ABSTRACT

Objective:
This study aimed to evaluate the efficacy of a bougie and glidescope video laryngoscope (GVL) for ground intubation by novice prehospital caregivers. We hypothesized that the intubation outcome using a bougie or GVL was superior to that using the Macintosh laryngoscope (MCL) with a stylet (MCLS) in ground intubation.
Method:
A randomized crossover manikin study was conducted. Studied groups were categorized into 4 according to the intubation devices used; MCLS, Macintosh laryngoscope with bougie (MCLB), glidescope video laryngoscope with a stylet (GVLS), and glidescope video laryngoscope with bougie (GVLB). The primary outcome was the total endotracheal intubation time and the secondary outcome was the success rate for endotracheal intubation.
Results:
The use of a bougie did not cause a significant difference in the intubation time (MCLS vs. MCLB, P=0.213; GVLS vs. GVLB, P=0.633) and the success rate of endotracheal intubation (MCLS vs. MCLB, P>0.990; GVLS vs. GVLB, P=0.077) was compared with the use of a stylet in MCL and GVL. The use of GVL showed a longer endotracheal intubation time compared with MCLS (MCLS vs. GVLS, P<0.001; MCLS vs. GVLB, P<0.001). GVLB showed a decreased success rate of endotracheal intubation compared with the use of MCL (MCLS vs. GVLB, P=0.004; MCLB vs. GVLB, P<0.001).
Conclusion:
The use of the GVL and a bougie could not affect the performance of endotracheal intubation on the ground. The use of MCL and a stylet for ground intubation could increase the intubation success rate and shorten intubation time compared with the use of a bougie or the use of GVL.

Key words: Intubation; Airway management; Simulation training