Evaluation of three oral intubation techniques in the AS365N2 Dauphin

Abstract

Introduction: Previous research demonstrated impaired performance of oral endotracheal intubation (ETI) in the AS365N2 Dauphin helicopter compared with other EMS aircraft. This study evaluates conventional (laryngoscopy) ETI and two alternatives: lighted-stylet (LS) and digital (DIG) intubation techniques. Methods: An intubating mannequin was used to evaluate in-cabin oral ETI performed by 17 flight crew members in a stationary AS365N2 Dauphin. Collected data included successful intratracheal placement frequency and ETI placement time. Chi-square and Fisher's tests ( p = .05) compared intratracheal placement among the three groups. Comparison of ETI times was accomplished by two-way ANOVA ( p = .05). Results: Intratracheal placement rate was highest in the conventional group, followed by the LS and the DIG group, respectively. Comparison of the LS and conventional intratracheal success rates did not achieve statistical significance. DIG group intratracheal success was significantly lower than either LS or conventional techniques. Time required to complete ETI was virtually identical among the three groups. Conclusion: Air medical crew members were able to perform successful ETI by the LS technique in the AS365N2, significantly surpassing the limited success of the DIG technique. Because the alternative techniques did not prolong ETI time, the techniques (particularly LS) appear to be appropriate for further investigation in the AS365N2 for patients in whom standard ETI fails.