Pediatric Intubation During Emergency Conditions

Study Overview
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Brief Summary
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The effectiveness of endotracheal intubation in pre-hospital conditions is insufficient - especially in the context of pediatric patients. Anatomical differences in pediatric patients compared to adults: a relative larger tongue, a larger and more flabby epiglottis - located more cephalously - that make intubation is more difficult than for adults. Also, higher oxygen metabolism requires the immediate response of medical personnel to children in case of need to protect the airways and support breath.

Official Title
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A Comparison of Direct vs. Video-laryngoscopes for Different Emergency Pediatric Airway Scenarios

Conditions
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Endotracheal Intubation, Pediatric, Cardiac Arrest, Injuries

Intervention / Treatment
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* Device: Macintosh laryngoscope
* Device: Miller laryngoscope
* Device: McGrath MAC EMS
* Device: GlideScope


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: paramedics give voluntary consent to participate in the study none experience in videolaryngoscopy less than 1 year experience in medicine Exclusion Criteria: not meet the above criteria wrist or low back diseases

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Normal airway scenario<br>intubation in normal airway scenario | Device: Macintosh laryngoscope<br>* intubation will be performed using standard direct laryngoscopy - Macintosh laryngoscope<br>* Other names: MAC;Device: Miller laryngoscope<br>* intubation will be performed using Miller laryngoscope<br>* Other names: MIL;Device: McGrath MAC EMS<br>* intubation will be performed using McGrath MAC EMS video - laryngoscope<br>* Other names: McGrath;Device: GlideScope<br>* intubation will be performed using GlideScope video - laryngoscope<br>* Other names: GLS;|
| Experimental: Tongue edema scenario<br>intubation in the tongue edema scenario. Tongue edema was obtain using simulator indicators | Device: Macintosh laryngoscope<br>* intubation will be performed using standard direct laryngoscopy - Macintosh laryngoscope<br>* Other names: MAC;Device: Miller laryngoscope<br>* intubation will be performed using Miller laryngoscope<br>* Other names: MIL;Device: McGrath MAC EMS<br>* intubation will be performed using McGrath MAC EMS video - laryngoscope<br>* Other names: McGrath;Device: GlideScope<br>* intubation will be performed using GlideScope video - laryngoscope<br>* Other names: GLS;|
| Experimental: Spinal immobilization with normal airway scenario<br>intubation in spinal immobilization with normal airway scenario | Device: Macintosh laryngoscope<br>* intubation will be performed using standard direct laryngoscopy - Macintosh laryngoscope<br>* Other names: MAC;Device: Miller laryngoscope<br>* intubation will be performed using Miller laryngoscope<br>* Other names: MIL;Device: McGrath MAC EMS<br>* intubation will be performed using McGrath MAC EMS video - laryngoscope<br>* Other names: McGrath;Device: GlideScope<br>* intubation will be performed using GlideScope video - laryngoscope<br>* Other names: GLS;|
| Experimental: Spinal immobilization with tongue edema scenario<br>endotracheal intubation with immobilized cervical spine and tongue edema scenario | Device: Macintosh laryngoscope<br>* intubation will be performed using standard direct laryngoscopy - Macintosh laryngoscope<br>* Other names: MAC;Device: Miller laryngoscope<br>* intubation will be performed using Miller laryngoscope<br>* Other names: MIL;Device: McGrath MAC EMS<br>* intubation will be performed using McGrath MAC EMS video - laryngoscope<br>* Other names: McGrath;Device: GlideScope<br>* intubation will be performed using GlideScope video - laryngoscope<br>* Other names: GLS;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intubation time | time in seconds required for a successful intubation attempt | 1 day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Success of intubation | If the oesopharyngeal tube was incorrectly placed or intubation lasted longer than 60 seconds, the airway-management attempt was defined as a failure. | 1 day | 
| Cormack-Lehane grading | self-reported percentage the vocal cord visualization using the Cormack-Lehane grading, scale developed by Cormack and Lehane, based on four degrees of visibility of the glottis. | 1 day | 
| POGO score - percentage of glottic opening | self-reported percentage the vocal cord visualization. A 100% POGO score is a full view of the glottis from the anterior commissure to the interarytenoid notch. A POGO score of 0 means that even the interarytenoid notch is not seen. | 1 day | 
| Preferred ETI device | participants were asked which method of ETI they would prefer in a real-life resuscitation. | 1 day | 
| Ease of use | self-reported percentage the vocal cord visualization. A 100% score is a extremely difficult procedure. A Ease of use score of 1% means that procedure is extremely easy | 1 day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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difficult airway, endotracheal intubation, chest compression, physician