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Completed

NCT Number: NCT07165314

Assessment of Provider Position for Prehospital Tracheal Intubation

Endotracheal intubation may be needed in critically ill patients in the prehospital setting, where difficult conditions may be encountered. The patient may be lying on the ground, thus complicating direct laryngoscopy as the operator's visual axis cannot be properly aligned with the patient's oral-pharyngeal-tracheal axis. The posture sitting cross-legged ("Lotus" position) at the head of the patient may allow an easier alignment of the visual axes due to a lower operator's head position and more stability. We compared the impact of the "Lotus" position with free positioning of the operator for direct laryngoscopy on intubation first pass success rate among novice operators.

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Key information

Conditions

Tracheal Intubation

Age range

18 year–50 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Hôpitaux Universitaires de Genève

Geneva, Canton of Geneva, 1205, Switzerland

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • All resident doctors with 1 to 6 years of post-graduate experience working in the Emergency Department (ED) at Geneva University Hospitals (Hôpitaux Universitaires de Genève (HUG)) and penultimate year of medical school students (5th year) studying at University of Geneva Faculty of Medicine (UGFM) - Performed less than 10 ETIs prior to take part in the research

Exclusion criteria

  • More than 6 years of post-graduate experience
  • Performed more than 10 ETIs prior to take part in the research

Treatment and study plan

Free positioning

Procedure

Participants are not given instructions on how to position for intubation using direct laryngoscopy.

Sitting cross-legged ("Lotus" position)

Procedure

Participants are requested to sit cross-legged for intubation using direct laryngoscopy.

Primary outcomes

  1. First Pass Success rate

    Time frame: Periprocedural

    In percentage, defined as achieving successful ETI on the initial attempt. An ETI attempt was counted since the laryngoscope blade was inserted at the dental arch, regardless of whether tracheal tube placement was attempted or not. ETI was considered successful when adequate ventilation was confirmed by chest elevation. The number of intubation attempts were limited to three, with a time limit of 60 seconds allowed per attempt.

Secondary outcomes

  1. Time to Intubation

    Time frame: Periprocedural

    Time in seconds from blade insertion at the dental arch to successful ventilation. A maximum of 60 seconds was allowed per ETI attempt.

  2. Time to Intubation for the first intubation attempt alone

    Time frame: Periprocedural

    Time in seconds from blade insertion at the dental arch to adequate ventilation, ruling out first-attempt failures. A maximum of 60 seconds was allowed per ETI attempt.

  3. Number of intubations attempts

    Time frame: Periprocedural

    An ETI attempt was counted since the laryngoscope blade was inserted at the dental arch, regardless of whether tracheal tube placement was attempted or not. ETI was considered successful when adequate ventilation was confirmed by chest elevation. The number of intubation attempts were limited to three, with a time limit of 60 seconds allowed per attempt.

  4. Cormack and Lehane (CL) score

    Time frame: Periprocedural

    For each attempt, the view of the larynx was assessed by the participant using the Cormack-Lehane score.

  5. Percentage Of Glottis Opening (POGO) score

    Time frame: Periprocedural

    For each attempt, the percentage of glottis opening was assessed by the participant, using the POGO score.

  6. Subjective assessments

    Time frame: Periprocedural

    Perceived difficulty was appraised using a 5-point Likert scale ranging from "Totally Agree" to "Totally Disagree".

Sponsors and collaborators

Lead sponsor

University Hospital, Geneva

Other

Registry information

Official study title

Assessment of Provider Position for Prehospital Tracheal Intubation Using Direct Laryngoscopy: Randomized Controlled Trial

Important dates

Study start
2023
Primary completion
2024
Study completion
2024
First posted
Sep 10, 2025
Registry last updated
Sep 10, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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