Prehospital and Emergency Feasibility of MACOCHA Score Assessment to Predict Difficult Tracheal Intubation

Completed

• Conditions: Emergency Medicine; Intubation, Intratracheal

• Registration Number: NCT03420027
• Lead Sponsor: Centre Hospitalier Régional d'Orléans

Brief Summary

A seven-item simplified score (the MACOCHA score) has been validated to predict difficult tracheal intubation in intensive care unit patients. In the prehospital or in the emergency department settings, no such validated predictive score is available yet. The aim of the present study is to assess the feasibility the quick calculation of the MACOCHA score before emergent intubation, in the prehospital and emergency department contexts.

Detailed Description

All patients who will have to undergo emergent tracheal intubation for any reason in the prehospital context or at the emergency department at a single 1100-bed regional and teaching hospital in France, will be included in this observational, prospective study, provided that neither the patient him/herself, if capable, or next-of-kin if present have declined participation.

Items of the MACOCHA score will be recorded before intubation by investigators, who are all certified emergency physicians skilled with urgent tracheal intubation.

For any intubation procedure, either in the out-of-hospital context or in the Emergency Department, one of these emergency physicians is always present.

The feasibility the quick MACOCHA score calculation before urgent intubation will be assessed by the number and percentages of patients for whom all the seven items of the score have been collected.

Study Timeline

• Study First Submitted: 2018-01-28
• Study First Submitted QC: 2018-01-28
• Study First Posted: 2018-02-05
• Study Start: 2018-03-01
• Status Verified: 2019-06
• Primary Completion: 2019-06-07
• Study Completion: 2019-06-07
• Last Update Submitted: 2019-06-07
• Last Update Posted: 2019-06-10

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 168

Inclusion Criteria

• Patient ≥ 18 yrs
• Patient who have to undergo rapid sequence tracheal intubation as judged by the Emergency Physician

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Exclusion Criteria

• Pregnancy
• Cardiac arrest of any cause as the indication for intubation
• Patient or next-of-kin declining participation

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
number of missing items of the MACOCHA score	5 minutes	The MACOCHA score is a predictive score of difficult intubation in intensive care to anticipate and prepare the appropriate equipment, possibly use an alternative strategy of intubation and call for help to reduce the risk of morbidity and mortality.; The MACOCHA score involves various simple assessment items: a Mallampati III or IV, a sleep apnea syndrome, a decrease in cervical mobility, a mouth opening \<3cm, a coma defined by a Glasgow score \<8, severe hypoxemia, and if the practitioner is not anesthetist.; Missing items are defined as those for which relevant information cannot be collected before intubation.

Secondary Outcome Measures

Name	Time	Method
Adverse events	30 min	occurrence of any adverse event during and 30 minutes after intubation

Trial Locations

Locations (1)

CHR d'Orléans; 🇫🇷 Orléans, France