Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2020 Jan;99(1):e18452.
doi: 10.1097/MD.0000000000018452.

Flexible tip bougie - the new introducer for intubation during cardiopulmonary resuscitation: A randomized crossover manikin study

Michał Bączek  1   2 , Michalina Zagańczyk-Bączek  1   3
Affiliations
Randomized Controlled Trial

Flexible tip bougie - the new introducer for intubation during cardiopulmonary resuscitation: A randomized crossover manikin study

Michał Bączek et al. Medicine (Baltimore). 2020 Jan.

Abstract

Background: The aim of this study was to compare three intubation methods during cardiopulmonary resuscitation using an adult-manikin.

Methods: Thirty-nine paramedics were included in this study. Each participant performed endotracheal intubation during continuous chest compressions using 3 different methods: conventional Macintosh laryngoscope without additional intubation aids (MAC), conventional Macintosh laryngoscope with gum-elastic bougie (GEB), or flexible tip bougie (FTB). First attempt intubation success rate and intubation time was measured.

Results: Intubation success rate was 39% with the use of MAC, 92% with GEB and 95% with FTB. It was statistically lower with MAC than with GEB (P < .001) and FTB (P < .001). There was no difference between GEB and FTB in intubation success rate (P = .644). The mean(SD) intubation time was 28.43 (13.81)s with MAC, 25.69 (5.35)s with GEB and 21.41 (2.88)s with FTB. Intubation time was significantly longer with GEB than with FTB (P < .001).

Conclusions: Within limitations, results of our study suggest that intubation aids facilitate tracheal intubation during continuous chest compressions. Using flexible tip bougie shortens the duration of the procedure compared to gum elastic bougie.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flexible tip bougie (A). Posterior (B) and anterior (C) flexion of the tip.
Figure 2
Figure 2
Randomization flow chart. FTB = flexible tip bougie, GEB = gum elastic bougie, MAC = conventional Macintosh laryngoscope.
Figure 3
Figure 3
Intubation success rate chart.
Figure 4
Figure 4
Mean intubation time using gum elastic bougie and flexible tip bougie.
See this image and copyright information in PMC

References

    1. Benjamin EJ, Muntner P, Alonso A, et al. Heart disease and stroke statistics—2019 update: a report from the American Heart Association. Circulation 2019;139:e56–28. - PubMed
    1. Ruben H, Johansen S. Gastric inflation due to artificial respiration. Acta Anaesthesiol Scand 1970;14:281–5. - PubMed
    1. Katz SH, Falk JL. Misplaced endotracheal tubes by paramedics in an urban emergency medical services system. Ann Emerg Med 2001;37:32–7. - PubMed
    1. Sayre M, Sakles J, Mistler A, et al. Field trial of endotracheal intubation by basic EMTs. Ann Emerg Med 1998;31:228–33. - PubMed
    1. Wang HE, Yealy DM. How many attempts are required to accomplish out-of-hospital endotracheal intubation? Acad Emerg Med 2006;13:372–7. - PubMed

Publication types

LinkOut - more resources