Assessment of Provider Position for Prehospital Tracheal Intubation

Not Applicable

Completed

• Conditions: Tracheal Intubation

• Registration Number: NCT07165314
• Lead Sponsor: University Hospital, Geneva

Brief Summary

Endotracheal intubation may be needed in critically ill patients in the prehospital setting, where difficult conditions may be encountered. The patient may be lying on the ground, thus complicating direct laryngoscopy as the operator's visual axis cannot be properly aligned with the patient's oral-pharyngeal-tracheal axis. The posture sitting cross-legged ("Lotus" position) at the head of the patient may allow an easier alignment of the visual axes due to a lower operator's head position and more stability. We compared the impact of the "Lotus" position with free positioning of the operator for direct laryngoscopy on intubation first pass success rate among novice operators.

Detailed Description

Not available

Study Timeline

• Study Start: 2023-09-01
• Primary Completion: 2024-04-30
• Study Completion: 2024-04-30
• Status Verified: 2025-09
• Study First Submitted: 2025-09-02
• Study First Submitted QC: 2025-09-02
• Last Update Submitted: 2025-09-02
• Study First Posted: 2025-09-10
• Last Update Posted: 2025-09-10

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 72

Inclusion Criteria

• All resident doctors 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 take part in the research

Exclusion Criteria

• More than 6 years of post-graduate experience
• Performed more than 10 ETIs prior to take part in the research

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
First Pass Success rate	Periprocedural	In percentage, defined as achieving successful ETI on the initial attempt. An ETI attempt was counted since the laryngoscope blade was inserted at the dental arch, regardless of whether tracheal tube placement was attempted or not. ETI was considered successful when adequate ventilation was confirmed by chest elevation. The number of intubation attempts were limited to three, with a time limit of 60 seconds allowed per attempt.

Secondary Outcome Measures

Name	Time	Method
Time to Intubation	Periprocedural	Time in seconds from blade insertion at the dental arch to successful ventilation. A maximum of 60 seconds was allowed per ETI attempt.
Time to Intubation for the first intubation attempt alone	Periprocedural	Time in seconds from blade insertion at the dental arch to adequate ventilation, ruling out first-attempt failures. A maximum of 60 seconds was allowed per ETI attempt.
Number of intubations attempts	Periprocedural	An ETI attempt was counted since the laryngoscope blade was inserted at the dental arch, regardless of whether tracheal tube placement was attempted or not. ETI was considered successful when adequate ventilation was confirmed by chest elevation. The number of intubation attempts were limited to three, with a time limit of 60 seconds allowed per attempt.
Cormack and Lehane (CL) score	Periprocedural	For each attempt, the view of the larynx was assessed by the participant using the Cormack-Lehane score.
Percentage Of Glottis Opening (POGO) score	Periprocedural	For each attempt, the percentage of glottis opening was assessed by the participant, using the POGO score.
Subjective assessments	Periprocedural	Perceived difficulty was appraised using a 5-point Likert scale ranging from "Totally Agree" to "Totally Disagree".

Trial Locations

Locations (1)

Hôpitaux Universitaires de Genève; 🇨🇭 Geneva, Canton of Geneva, Switzerland