Flexible Tip Bougie for Emergency Tracheal Intubation by Paramedics and Emergency Physicians

Q3 Nursing
Aditya C. Shekhar , Michael Altman-Ezzard , Joshua Kimbrell , Jacob Stebel , Evan Ashley , Avir Mitra , Timothy Friedmann , Ethan E. Abbott , Christopher Strother , Jared Kutzin
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引用次数: 0

Abstract

Objective

Given the consequences of failed intubation, there is great interest in optimizing airway management success rates. Growing evidence suggests that use of a bougie device is associated with improved airway success. Bougies with a flexible tip may increase intubation success by offering operators greater control. In this study, we performed a feasibility assessment of flexible tip bougies involving clinicians who routinely perform emergency airway management.

Methods

We used a feasibility simulation study design with pre- and postsurveys. Participants first completed a presession survey asking about their intubation experience and preferences. They were then given a brief demonstration of the flexible tip bougie with an opportunity to ask questions. They completed 2 intubations on an airway simulator using video laryngoscopy—one with a flexible tip bougie and one with a standard bougie. During these intubations, the time required to pass the bougie through the vocal cords and the time required to pass a tracheal tube through the vocal cords was assessed. Participants finally completed a postsession survey asking about their experiences with the flexible tip bougie.

Results

A total of 18 participants took part in the study. All participants rated themselves as familiar with tracheal intubation, and most (72.2%) said that they would consider using a flexible tip bougie on future intubations. Quantitatively, there was no clinically significant difference in the time needed to pass the bougie through the vocal cords (0.38 second) and the time needed to pass a tracheal tube through the vocal cords (8.24 seconds).

Conclusion

Our simulation-based study comparing a flexible tip bougie with a conventional bougie revealed improved operator feedback with the flexible tip bougie and a clinically insignificant temporal difference in intubation metrics. Further study is needed to better assess the benefits of a flexible tip bougie in emergency and nonemergency airway management.
护理人员和急诊医师用于紧急气管插管的柔性尖端布基
目的考虑到气管插管失败的后果,优化气道管理成功率具有重要意义。越来越多的证据表明,使用充气装置与改善气道成功率有关。具有灵活尖端的导管可以为操作人员提供更好的控制,从而提高插管成功率。在这项研究中,我们进行了一项可行性评估,包括临床医生经常进行急诊气道管理。方法采用可行性模拟研究设计,进行前后调查。参与者首先完成了一份问卷,询问他们的插管经历和偏好。然后,他们被简短地展示了这种可弯曲的尖端,并有机会提问。他们使用视频喉镜在气道模拟器上完成了2例插管,其中1例使用柔性尖端导管,另1例使用标准导管。在这些插管过程中,评估导管通过声带所需的时间和气管导管通过声带所需的时间。最后,参与者完成了一项会后调查,询问他们使用柔性小费的体验。结果共有18名参与者参加了这项研究。所有参与者都认为自己熟悉气管插管,大多数(72.2%)表示他们会考虑在未来插管时使用灵活的尖端导管。从数量上看,导管通过声带所需时间(0.38秒)和气管插管通过声带所需时间(8.24秒)在临床上无显著差异。我们基于模拟的研究比较了灵活的尖端弓突和传统的弓突,发现使用灵活的尖端弓突可以改善操作人员的反馈,并且在插管指标上具有临床上不显著的时间差异。需要进一步的研究来更好地评估柔性尖端支架在急诊和非急诊气道管理中的益处。
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来源期刊
Air Medical Journal
Air Medical Journal Nursing-Emergency Nursing
CiteScore
1.20
自引率
0.00%
发文量
112
审稿时长
69 days
期刊介绍: Air Medical Journal is the official journal of the five leading air medical transport associations in the United States. AMJ is the premier provider of information for the medical transport industry, addressing the unique concerns of medical transport physicians, nurses, pilots, paramedics, emergency medical technicians, communication specialists, and program administrators. The journal contains practical how-to articles, debates on controversial industry issues, legislative updates, case studies, and peer-reviewed original research articles covering all aspects of the medical transport profession.
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