Use of the endotracheal tube introducer as an adjunct for oral tracheal intubation in the prehospital setting.

Abstract

To prospectively evaluate the effectiveness of the endotracheal tube introducer (ETTI) versus standard orotracheal intubation (SOTI) in the prehospital air medical setting. Critically ill patients were randomized to ETTI versus SOTI based on an odd/even day regimen. Data were collected on initial intubation attempt used, success using initial approach, number of intubation attempts until success, and laryngeal view encountered. The 2 approaches then were compared and statistically analyzed. Fifty-one patients were entered into the 10-month study; 20 patients were randomized to the ETTI group and 31 to SOTI. Overall success rate for first intubation attempt was 70% for the ETTI and 65% SOTI (P =.67). Total intubation time was 62 seconds (95% CI = 16-108) for the ETTI versus 62 seconds (95% CI = 38-86) for SOTI (P =.4). The ETTI group had a higher percentage of intubating difficult laryngeal views (grade 3 and 4) on first attempts than SOTI. In this study, the authors found the ETTI to be a safe airway adjunct with results equal to SOTI. The ETTI may have a useful role in prehospital airway management.