Comparison of the intubation effectiveness of direct laryngoscopy, video laryngoscopy and gum elastic spuige prehospitals

AIM: In this study, direct laryngoscopy (DL), video laryngoscopy (VL) and gum elastic bougie (GEB) methods, which are among the endotracheal intubation (ETE) methods used before the hospital; We aimed to compare intubation and laryngoscopy times, laryngoscopic view degrees, success rates and ease of intubation in the pre- hospital ambulance environment and to present it to healthcare professionals. MATERIALS AND METHODS: Our study; it was planned as a randomized, prospective and crossover study. The study was conducted by including first-year emergency medical technicians and paramedics who had no previous intubation experience. The participants had ETE performed on an airway manikin using three methods; DL, VL and GEB in pre-hospital immobile ambulance (Scenario 1) and mobile ambulance (Scenario 2) environments. The data of the procedures were recorded and analyzed statistically, p <0.05 values were considered significant. RESULTS: When the rima glottis visualization times in the 3 types of ETE were compared in both Scenario 1 and Scenario 2, a statistically significant difference was detected between the 3 groups (p<0.001). A statistically significant difference was detected in tube placement times between DL and VL in Scenario 1 and Scenario 2 (p<0.001, p=0.003, respectively). A statistically significant difference was detected in total intubation time between DL and VL in scenario 1 and scenario 2 (p=0.02, p=0.006, respectively). CONCLUSION: In our study, it was found that the VL method shortened the ETE time and increased success in both scenarios. When image clarity was evaluated, it was determined that the VL method was more successful in both scenarios. While the VL method had the highest first pass success rates, the GEB method was also found to have higher rates than the DL method. In light of our results; We think that VL and GEB are ideal and effective methods in prehospital ETE processes.