A Comparison Between Using Video Stylet and Video Laryngoscope in Difficult Intubation of Traumatic Patients .

Assiut University

Status: Completed

Conditions: Difficult or Failed Intubation

Treatments: Device: Intubation

Study type: Interventional

Funder types: Other

Identifiers

NCT05143346

Difficult intubation

Details and patient eligibility

About

The aim of this study is to compare the visualization of the glottis, the time for tracheal intubation, the success rate of intubation, and the need for manoeuvres to optimize the view using video stylet or video laryngoscope in patients with expected difficult intubations.

Full description

The airway, breathing and circulation support '' ABCs" of trauma resuscitation were born from the assumption that correcting hypoxemia and hypotension reduces morbidity and mortality. Definitive care for severely injured or polytrauma patients includes the ability to provide advanced airway management in a variety of settings: in the emergency department, 20% to 30% intubations are for trauma. Airway management in traumatic patient presents numerous unique challenges beyond placement of an endotracheal tube, without comes dependent on the provider's ability to predict and anticipate difficulty and have a safe and executable plan. In severely injured patients, the cervical spine must be protected by in-line immobilisation during airway management. If orotracheal intubation is required, then manual in-line stabilisation is recommended to facilitate tracheal intubation to secure a space for tongue displacement into the submandibular space. However, manual in-line stabilisation can make alignment of the oral, pharyngeal and laryngeal axes difficult, resulting in a poor direct laryngoscopic view and prolonging the intubation time. Video stylets, which are portable and easier to prepare than flexible fiberoptic bronchoscopes, could be better option for tracheal intubation in patient with cervical immobilization. Previous studies have shown the usefulness of video stylets for tracheal intubation in cervical immobilized patients.

Video laryngoscopes provide a better laryngeal view. They are easy to use and have a high success rate and short intubation time in patients with predicted difficult airways. Successful use of video laryngoscopy is increasing for airway management of patients with trauma in the emergency department.

Enrollment: 66 patients

Sex: All

Ages: 5 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Any patient in the age group of (5 - 80) and has
• Suspected difficult intubation.
• High mallampati score (class 111, 1V).
• Suspected cervical fracture.
• Maxillofacial trauma.
• Fracture base of the skull.
• Polytrauma.

Exclusion criteria

• Patients with low mallampati score (class 1, 11).
• Patients undergoing elective surgeries and not suspected to have difficult intubations.
• Patients aged below 5 years and above 80 years.

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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66 participants in 2 patient groups

Group A

Other group

Description:

Group A will include 33 patients and will be intubated by the use of video stylet.

Treatment:

Device: Intubation

Group B

Other group

Description:

Group B will include 33 patients and will intubated by the use of video laryngoscope

Treatment:

Device: Intubation