Difficult IntubationNCT03419507
A Comparison of a Macintosh Laryngoscope and Endotracheal Tube Introducer in a Manikin
A study testing Endotracheal tube introducer and Macintosh laryngoscopy in people with Difficult Intubation, run by Derince Training and Research Hospital at 1 site in Turkey (Türkiye).
Trial summary
In this prospective, randomized, cross-over study, investigators aimed to compare the first pass successes of inexperienced doctors with Macintosh laryngoscopy and endotracheal tube introducer on a manikin with continuous chest compression in the ambulance simulation in the pre-hospital process. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Difficult Intubation
- What is being tested?
- Endotracheal tube introducer and Macintosh laryngoscopy
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 10 Feb 2018to 10 Mar 2018
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- novice doctors who accept to participate the study
Who cannot join
- novice doctors who won't accept to participate the study
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
Derince training and educational hospital
Kocaeli, Derince, 41300
About this study
Official title: Comparison of a Macintosh Laryngoscope and Endotracheal Tube Introducer During Chest Compression in a Manikin: Randomized, Prospective, Cross-over Study
In this prospective, randomized, cross-over study, investigators aimed to compare the first pass successes of inexperienced doctors with Macintosh laryngoscopy and endotracheal tube introducer on a manikin with continuous chest compression in the ambulance simulation in the pre-hospital process.
Read the detailed description
This study is a prospective, cross-over manikin study which is based on an ambulance simulation. Written inform consent was obtained from all doctors who agreed to participate to the study. Inexperienced doctors who attended in Kocaeli between February 2018 and March 2018 will be included to the survey. Novice doctors participated to this research. The research will be carried out in the department of emergency medicine of Derince training and research hospital. In order to prevent bias, the eight-hour training module for the participants , theoretical and practical airway training will be provided by an emergency medical specialist who has no knowledge about the research.
The participants will be informed about the study after the training. Doctors who participate to the study will be included after the written inform consent is obtained. The participants will be informed about the research, but they will be blind to the specific purposes of the study. The participants will practice for 5 minutes on the manikin by themselves and with the emergency medicine specialist if they ask for. Life / form® Deluxe Crisis ™ Manikin Torso with Advanced Airway Management will be used as the research manikin. The participants will perform airway interventions in the sitting position and the height of the stretcher will be set at the same height with the ambulance stretcher. Practitioner's seat will be set on the same height with the ambulance seat. 8.0 (mm ID) endotracheal tube will be used for the procedure. Endotracheal tube and manikin airway will be lubricated with pump spray lubricant provided with the simulator. Airway manikin will be in supine position. Lund University Cardiac Arrest System-version 2 (LUCAS 2TM) automatic chest compression device will be used to provide 5 cm compression depth and 100 chest compressions per minute in order to provide standardization in chest compression and prevent bias created by practitioners. The airway devices will be next to the model's head.
The study was planned as a randomized, crossover clinical trial to reduce the influence of the learning. Equal numbers 1 and 2 will be written on the same sized papers to provide randomization. All papers will be folded in the same way and placed inside brown and invisible envelopes. All of the envelopes will be placed in the same box. After the training, every doctor will be asked to choose one of the envelopes. After separating the participants into two groups, doctors that drawed envelop number 1 will be asked to intubate by using only No. 3 Macintosh blade. The doctors that drawed envelop number 2 will be asked to intubate with the adult size endotracheal tube introducer with using No. 3 Macintosh laryngoscopy.
After the groups completed their interventions, those who drawed envelope number 1 will be asked to intubate with Macintosh laryngoscopy using endotracheal tube introducer and those who drawed envelope number 2 will be asked to intubate with Macintosh laryngoscopy. Each doctor will be given 1 minute for each successful intervention. Each practitioner will make maximum 2 trial attempts for each method. The initiation time is considered to be taking the laryngoscopy on hand. After ventilation, the manikin's chest wall movement is considered as a successful intervention. All transactions will be recorded with a camera that is placed in the room and the participants will have the information about the presence of the camera. The first intervention success , intubation time, the number of interventions of the participants will be recorded. After the interventions are over, the participants will be asked to rate the difficulty of the ventilation methods according to the Likert scale as 1-very easy, 2-easy, 3-medium, 4-difficult 5- very difficult. In addition, they will be asked whether they have any experiences with Macintosh laryngoscopy or endotracheal tube introducer and their responses will be recorded.
- Conditions
- Difficult Intubation
- Being tested
- Endotracheal tube introducer, Macintosh laryngoscopy
- Keywords
- endotracheal tube introducer, manikin, chest compression
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Endotracheal tube introducerDevice
The doctors that drawed envelop number 2 will be asked to intubate with laryngoscope by the adult size, endotracheal tube introducer with using No. 3 Macintosh blade
Macintosh laryngoscopyDevice
The doctors who drawed envelope number 1 will asked to intubate with using No. 3 Macintosh blade
| Study group | Role | What they receive |
|---|---|---|
| Macintosh group | Active comparator | After separating participants into two groups, doctors that drawed envelop number 1 will be asked to intubate with laryngoscope by using No. 3 Macintosh laryngoscope Receives: Device: Macintosh laryngoscopy |
| Endotracheal tube introducer group | Active comparator | After separating participants into two groups, doctors that drawed envelop number 2 will be asked to intubate with laryngoscope by using the adult size endotracheal tube introducer with using No. 3 Macintosh laryngoscope. Receives: Device: Endotracheal tube introducer |
What is being measured
The primary outcome is the main question the study is designed to answer.
First pass success
The primary outcome measure of the survey is determined as the first pass success of the doctors.
Measured: 1 minute
Secondary outcomes (3)
intubation duration
The initiation time is considered to be taking the laryngoscope on hand. Successful ventilation of the manikin with a balloon valve mask is considered as the ending time of the intervention.
Measured: 1 minute
Intervention numbers
All of the interventions will be recorded with a camera
Measured: 1 minute
Difficulty levels of the methods
Difficulty levels of the methods on the Likert scale.
Measured: 2 minutes
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 Feb 2018
- Study start10 Feb 2018
- Primary completion10 Mar 2018
- Study completion10 Mar 2018
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Difficult IntubationStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Crossover
- Model description
- Equal numbers 1 and 2 will be written on the same sized papers. After separating participants into two groups, doctors that drawed envelop number 1 will be asked to intubate with No. 3 Macintosh laryngoscopy and doctors that drawed envelop number 2 will be asked to intubate with endotracheal tube introducer. Than groups will be changed.
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 40 participants (actual)
Sponsor and investigators
- Lead sponsor
- Derince Training and Research Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Hüseyin Cahit Halhallı, Derince Training and Research Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03419507
- Sponsor's protocol ID
- 2017/16. 15/351
- Status last verified
- Mar 2018
- First submitted
- 18 Jan 2018
- Last updated
- 29 Mar 2018
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided: undecided
Publications
Murat I, Constant I, Maud'huy H. Perioperative anaesthetic morbidity in children: a database of 24,165 anaesthetics over a 30-month period. Paediatr Anaesth. 2004 Feb;14(2):158-66. doi: 10.1111/j.1460-9592.2004.01167.x.
PubMed 14962332Bhananker SM, Ramamoorthy C, Geiduschek JM, Posner KL, Domino KB, Haberkern CM, Campos JS, Morray JP. Anesthesia-related cardiac arrest in children: update from the Pediatric Perioperative Cardiac Arrest Registry. Anesth Analg. 2007 Aug;105(2):344-50. doi: 10.1213/01.ane.0000268712.00756.dd.
PubMed 17646488Fiadjoe JE, Nishisaki A, Jagannathan N, Hunyady AI, Greenberg RS, Reynolds PI, Matuszczak ME, Rehman MA, Polaner DM, Szmuk P, Nadkarni VM, McGowan FX Jr, Litman RS, Kovatsis PG. Airway management complications in children with difficult tracheal intubation from the Pediatric Difficult Intubation (PeDI) registry: a prospective cohort analysis. Lancet Respir Med. 2016 Jan;4(1):37-48. doi: 10.1016/S2213-2600(15)00508-1. Epub 2015 Dec 17.
PubMed 26705976Jabre P, Combes X, Leroux B, Aaron E, Auger H, Margenet A, Dhonneur G. Use of gum elastic bougie for prehospital difficult intubation. Am J Emerg Med. 2005 Jul;23(4):552-5. doi: 10.1016/j.ajem.2004.12.005.
PubMed 16032630Kidd JF, Dyson A, Latto IP. Successful difficult intubation. Use of the gum elastic bougie. Anaesthesia. 1988 Jun;43(6):437-8. doi: 10.1111/j.1365-2044.1988.tb06625.x.
PubMed 3407866
Study at a glance
From the registry record, last updated by the sponsor on 29 Mar 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of a Macintosh Laryngoscope and Endotracheal Tube Introducer During Chest Compression in a Manikin: Randomized, Prospective, Cross-over Study
- ClinicalTrials.gov ID
- NCT03419507
- Acronym / sponsor ID
- 2017/16. 15/351
- Conditions
- Difficult Intubation
- Keywords
- endotracheal tube introducer, manikin, chest compression
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 40 participants (actual)
- Lead sponsor
- Derince Training and Research HospitalUniversity, hospital or other
- Study start
- 10 Feb 2018 (actual)
- Primary completion
- 10 Mar 2018 (actual)
- Study completion
- 10 Mar 2018 (actual)
- First posted
- 5 Feb 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
In this prospective, randomized, cross-over study, investigators aimed to compare the first pass successes of inexperienced doctors with Macintosh laryngoscopy and endotracheal tube introducer on a manikin with continuous chest compression in the ambulance simulation in the pre-hospital process.
Detailed description
This study is a prospective, cross-over manikin study which is based on an ambulance simulation. Written inform consent was obtained from all doctors who agreed to participate to the study. Inexperienced doctors who attended in Kocaeli between February 2018 and March 2018 will be included to the survey. Novice doctors participated to this research. The research will be carried out in the department of emergency medicine of Derince training and research hospital. In order to prevent bias, the eight-hour training module for the participants , theoretical and practical airway training will be provided by an emergency medical specialist who has no knowledge about the research.
The participants will be informed about the study after the training. Doctors who participate to the study will be included after the written inform consent is obtained. The participants will be informed about the research, but they will be blind to the specific purposes of the study. The participants will practice for 5 minutes on the manikin by themselves and with the emergency medicine specialist if they ask for. Life / form® Deluxe Crisis ™ Manikin Torso with Advanced Airway Management will be used as the research manikin. The participants will perform airway interventions in the sitting position and the height of the stretcher will be set at the same height with the ambulance stretcher. Practitioner's seat will be set on the same height with the ambulance seat. 8.0 (mm ID) endotracheal tube will be used for the procedure. Endotracheal tube and manikin airway will be lubricated with pump spray lubricant provided with the simulator. Airway manikin will be in supine position. Lund University Cardiac Arrest System-version 2 (LUCAS 2TM) automatic chest compression device will be used to provide 5 cm compression depth and 100 chest compressions per minute in order to provide standardization in chest compression and prevent bias created by practitioners. The airway devices will be next to the model's head.
The study was planned as a randomized, crossover clinical trial to reduce the influence of the learning. Equal numbers 1 and 2 will be written on the same sized papers to provide randomization. All papers will be folded in the same way and placed inside brown and invisible envelopes. All of the envelopes will be placed in the same box. After the training, every doctor will be asked to choose one of the envelopes. After separating the participants into two groups, doctors that drawed envelop number 1 will be asked to intubate by using only No. 3 Macintosh blade. The doctors that drawed envelop number 2 will be asked to intubate with the adult size endotracheal tube introducer with using No. 3 Macintosh laryngoscopy.
After the groups completed their interventions, those who drawed envelope number 1 will be asked to intubate with Macintosh laryngoscopy using endotracheal tube introducer and those who drawed envelope number 2 will be asked to intubate with Macintosh laryngoscopy. Each doctor will be given 1 minute for each successful intervention. Each practitioner will make maximum 2 trial attempts for each method. The initiation time is considered to be taking the laryngoscopy on hand. After ventilation, the manikin's chest wall movement is considered as a successful intervention. All transactions will be recorded with a camera that is placed in the room and the participants will have the information about the presence of the camera. The first intervention success , intubation time, the number of interventions of the participants will be recorded. After the interventions are over, the participants will be asked to rate the difficulty of the ventilation methods according to the Likert scale as 1-very easy, 2-easy, 3-medium, 4-difficult 5- very difficult. In addition, they will be asked whether they have any experiences with Macintosh laryngoscopy or endotracheal tube introducer and their responses will be recorded.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Single blind (participant)
- Number of arms
- 2
- Model description
- Equal numbers 1 and 2 will be written on the same sized papers. After separating participants into two groups, doctors that drawed envelop number 1 will be asked to intubate with No. 3 Macintosh laryngoscopy and doctors that drawed envelop number 2 will be asked to intubate with endotracheal tube introducer. Than groups will be changed.
| Arm | Type | Receives |
|---|---|---|
| Macintosh group | Active comparator | Device: Macintosh laryngoscopyAfter separating participants into two groups, doctors that drawed envelop number 1 will be asked to intubate with laryngoscope by using No. 3 Macintosh laryngoscope |
| Endotracheal tube introducer group | Active comparator | Device: Endotracheal tube introducerAfter separating participants into two groups, doctors that drawed envelop number 2 will be asked to intubate with laryngoscope by using the adult size endotracheal tube introducer with using No. 3 Macintosh laryngoscope. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- novice doctors who accept to participate the study
Key exclusion criteria (1 listed)
- novice doctors who won't accept to participate the study
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Endotracheal tube introducerThe doctors that drawed envelop number 2 will be asked to intubate with laryngoscope by the adult size, endotracheal tube introducer with using No. 3 Macintosh blade | Device | Endotracheal tube introducer group |
| Macintosh laryngoscopyThe doctors who drawed envelope number 1 will asked to intubate with using No. 3 Macintosh blade | Device | Macintosh group |
Primary outcome
First pass success
Time frame: 1 minute
The primary outcome measure of the survey is determined as the first pass success of the doctors.
3 secondary outcomes
intubation duration
Time frame: 1 minute
Intervention numbers
Time frame: 1 minute
Difficulty levels of the methods
Time frame: 2 minutes
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Mar 2018.
- Background: PubMed 14962332Murat I, Constant I, Maud'huy H. Perioperative anaesthetic morbidity in children: a database of 24,165 anaesthetics over a 30-month period. Paediatr Anaesth. 2004 Feb;14(2):158-66. doi: 10.1111/j.1460-9592.2004.01167.x.
- Background: PubMed 17646488Bhananker SM, Ramamoorthy C, Geiduschek JM, Posner KL, Domino KB, Haberkern CM, Campos JS, Morray JP. Anesthesia-related cardiac arrest in children: update from the Pediatric Perioperative Cardiac Arrest Registry. Anesth Analg. 2007 Aug;105(2):344-50. doi: 10.1213/01.ane.0000268712.00756.dd.
- Background: PubMed 26705976Fiadjoe JE, Nishisaki A, Jagannathan N, Hunyady AI, Greenberg RS, Reynolds PI, Matuszczak ME, Rehman MA, Polaner DM, Szmuk P, Nadkarni VM, McGowan FX Jr, Litman RS, Kovatsis PG. Airway management complications in children with difficult tracheal intubation from the Pediatric Difficult Intubation (PeDI) registry: a prospective cohort analysis. Lancet Respir Med. 2016 Jan;4(1):37-48. doi: 10.1016/S2213-2600(15)00508-1. Epub 2015 Dec 17.
- Background: PubMed 16032630Jabre P, Combes X, Leroux B, Aaron E, Auger H, Margenet A, Dhonneur G. Use of gum elastic bougie for prehospital difficult intubation. Am J Emerg Med. 2005 Jul;23(4):552-5. doi: 10.1016/j.ajem.2004.12.005.
- Background: PubMed 3407866Kidd JF, Dyson A, Latto IP. Successful difficult intubation. Use of the gum elastic bougie. Anaesthesia. 1988 Jun;43(6):437-8. doi: 10.1111/j.1365-2044.1988.tb06625.x.
- The difficult pediatric airway - UpToDate \[Internet\]. Jul 31. 2017Link provided by the sponsor.
- Individual participant dataSharing planned: Undecided. undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Endotracheal tube introducer and Macintosh laryngoscopy in people with Difficult Intubation, run by Derince Training and Research Hospital at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 29 Mar 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
First pass success (time frame: 1 minute). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03419507, which also lists 5 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Mar 2018.