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Completed

NCT Number: NCT06918717

Prehospital Tracheal Intubation Technique Using Initial Direct Laryngoscopy During Videolaryngoscopy

Tracheal intubation using videolaryngoscopy may be required in the prehospital setting, where airway management presents unique technical and logistical challenges. Intubation may be hard because novice providers performing videolaryngoscopy may only look at the screen and only obtain a two-dimensional representation of the patient's airways. By directly visualizing the airways, these providers may obtain a better 3D apprehension and an improved mental visualization of the patient's anatomy. We aim to compare the impact of a freely realized videolaryngoscopy sequence with a sequence consisting in direct visualization of the airway followed by videolaryngoscopy ("Direct Laryngoscopy-to-VideoLaryngoscopy sequence" or "DL-VL sequence") on time to intubation among novice providers.

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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 physicians 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 participating in the study.

Exclusion criteria

  • More than 6 years of post-graduate experience
  • Performed more than 10 ETIs prior to participating in the study.

Treatment and study plan

Direct Laryngoscopy-to-VideoLaryngoscopy sequence

Procedure

Participants will proceed with a double intubation technique sequence, first performing an initial direct laryngoscopy without looking at the video screen until they reached the epiglottis, then performing an indirect lryngoscopy for intubation.

Free use of videolaryngoscopy

Procedure

Participants are free to use of the videolaryngoscope as they intended

Primary outcomes

  1. Time to Intubation

    Time frame: Periprocedural

    Time in seconds from blade insertion at the dental arch to adequate tracheal tube placement through the vocal cords, confirmed by the C-MAC video recording. A maximum of 60 seconds was allowed per ETI attempt. The maximum number of ETI attempts was limited to 3.

Secondary outcomes

  1. Time to Intubation for the first intubation attempt alone

    Time frame: Periprocedural

    Time in seconds from blade insertion at the dental arch to adequate tracheal tube placement through the vocal cords, confirmed by the C-MAC video recording. A maximum of 60 seconds was allowed per ETI attempt.

  2. First Pass Success rate

    Time frame: Periprocedural

    Intubation first pass success rate, in percentage.

  3. Number of intubations attempts

    Time frame: Periprocedural

    An ETI attempt was defined as the insertion of the laryngoscope blade at the dental arch, regardless of whether tracheal tube placement was attempted. A maximum of 60 seconds was allowed per ETI attempt. The maximum number of ETI attempts was limited to 3. More than 3 attempts, it was considered as failed.

  4. Time to Ventilation

    Time frame: Periprocedural

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

  5. Subjective assessments

    Time frame: Periprocedural

    Subjective assessments, including perceived difficulty (Question 1 - I found intubation easy. Question 2 - I felt comfortable intubating this way. Question 3 - I think the use of the VL was adequate to intubate OR I think the sequenced use of the VL helped me intubate. Question 4 - In a future similar clinical situation, I will make the same use of the VL to intubate OR I think doing a direct laryngoscopy before looking at the screen allows for faster intubation than doing an indirect laryngoscopy only. Question 5 - In a future similar clinical situation, I will make a different use of the VL to intubate OR In a future similar clinical situation, I will make the same use (DL-VL) of the VL to intubate. Question 6 - In a future similar clinical situation, I will make a different use (VL only) of the VL to intubate.), were 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 Prehospital Tracheal Intubation Technique Using Initial Direct Laryngoscopy During Videolaryngoscopy: Randomized Controlled Simulated Trial

Important dates

Study start
2023
Primary completion
2024
Study completion
2024
First posted
Apr 9, 2025
Registry last updated
Apr 9, 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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