Clinical trial NCT03808896: TCHCCT-Zhong-Xing-Emergency-Department-airway-clincal (TTC)
Official title: Taipei City Hospital ZhongXing Branch, Emergency Department
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Intubation;Difficult
Intubation Complication
Lead sponsor: Taipei City Hospital
Sponsor class: OTHER_GOV
First posted: 2019-01-18
Enrollment: 200
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Traditional intubation technique direct and video laryngoscope, bougie-assisted intubation, intubation with stylet assisted epiglottis lifting
Primary purpose: TREATMENT

Brief summary: In the previous study on mannekin, the investigators found stylet-assisted lifting of epiglottis is an useful technique on difficult airway (Cormack-Lehane grade IIIa, IIIb) without increasing subjective difficulty. It has no expenses other than the routine intubation process. Recently, the studies have proved that the bougie-assisted laryngoscopy can improve first pass intubation rate in the emergency department. However, bougie is a disposable device and may increased medical expenditure. The investigators will evaluate the safety of bougie and epiglottic lifting technique, as well as the first pass and overall success rate of intubation comparing to traditional video laryngoscopy and direct laryngoscopy.

Detailed description: A better strategy of managing Cormack-Lehane Grade III had been investigated by our previous study. The investigators' research results had been accepted and published by the journal BioMeidcal Central Anesthesiology. The investigators will be eager to do the further clinical trial to investigate the impact of this technique clinically. Besides, bougie assisted intubation is a effective, evidenced-proved intervention. The investigators will also like to find out the prognosis differences between these two techniques.

Eligibility criteria: Inclusion Criteria:

* all the patients present to the emergency department with airway emergency who need intubation

Exclusion Criteria:

* age below 18 year-old

Primary outcomes:
measure: first pass success rate
timeFrame: through the intubation period, an average of 90 seconds
measure: duration of intubation
timeFrame: through the intubation period, an average of 90 seconds
Secondary outcomes:
measure: Immediate complications direct related to intubation process
timeFrame: through the intubation period, an average of 90 seconds
measure: Overall success rate
timeFrame: within 48 hours of intubation
Other outcomes:
Locations:
city: Taipei
country: Taiwan
facility: Taipei City Hospital Zhong-Xing branch
Study officials:
References:
citation: Driver B, Dodd K, Klein LR, Buckley R, Robinson A, McGill JW, Reardon RF, Prekker ME. The Bougie and First-Pass Success in the Emergency Department. Ann Emerg Med. 2017 Oct;70(4):473-478.e1. doi: 10.1016/j.annemergmed.2017.04.033.
citation: Ueda W, Arai YP. The Use of a Stylet to Aid the Lifting of the Epiglottis With a Video Laryngoscope. Anesth Pain Med. 2016 May 24;6(4):e38507. doi: 10.5812/aapm.38507. eCollection 2016 Aug.