Prehospital Tracheal Intubation Technique Using Initial Direct Laryngoscopy During Videolaryngoscopy

NCT06918717 | Completed

• 1 other identifier: Req-2023-00073
• Study Type: interventional
• Target: 72
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Tracheal Intubation

Keywords

Advanced airway management; direct laryngoscopy; tracheal intubation; prehospital; videolaryngoscopy

Outcome Measures

Primary Outcomes (1)

• Time to Intubation

  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.

  Periprocedural

Secondary Outcomes (5)

• Time to Intubation for the first intubation attempt alone

  Periprocedural

• First Pass Success rate

  Periprocedural

• Number of intubations attempts

  Periprocedural

• Time to Ventilation

  Periprocedural

• Subjective assessments

  Periprocedural

Study Arms (2)

Free use of videolaryngoscopy

ACTIVE COMPARATOR

Procedure: Free use of videolaryngoscopy

Direct Laryngoscopy-to-VideoLaryngoscopy sequence

EXPERIMENTAL

Procedure: Direct Laryngoscopy-to-VideoLaryngoscopy sequence

Interventions

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.

Direct Laryngoscopy-to-VideoLaryngoscopy sequence

Free use of videolaryngoscopy PROCEDURE

Participants are free to use of the videolaryngoscope as they intended

Free use of videolaryngoscopy

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• 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.

You may not qualify if:

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

Sponsors & Collaborators

• University Hospital, Geneva: lead

Study Sites (1)

Hôpitaux Universitaires de Genève

Geneva, Canton of Geneva, 1205, Switzerland

Location

Related Publications (1)

• Cibotto C, Pasquier M, Beysard N, Rouyer F, Grosgurin O, Bourgeois L, Erriquez E, Braun E, Gartner BA, Desmettre T, Suppan L. Assessment of prehospital tracheal intubation technique using initial direct laryngoscopy during videolaryngoscopy: randomized controlled simulated trial. BMC Emerg Med. 2025 Jul 1;25(1):112. doi: 10.1186/s12873-025-01266-0.

  PMID: 40596822 DERIVED

Study Officials

• PD Dr Laurent Suppan

  University Hospital, Geneva

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: March 26, 2025
• First Posted: April 9, 2025
• Study Start: September 10, 2023
• Primary Completion: April 20, 2024
• Study Completion: August 15, 2024
• Last Updated: April 9, 2025

Record last verified: 2025-04

Locations

CH (1)