The comparison of endotracheal intubation and laryngeal tube insertion with face-to-face method in in-vehicle traffic accidents.

Abstract

Emergency airway management is a critical focus in prehospital emergency healthcare. The right technique and the right equipment may increase survival. The study aimed to compare endotracheal intubation and laryngeal tube insertion with the face-to-face method in difficult conditions such as in-vehicle traffic accidents in which the injured person is trapped inside the vehicle. The population of the study, which was carried out as experimental research, consisted of emergency health workers currently working in Bursa 112 Ambulance Services (n: 383). The study compared two different airway applications with face-to-face techniques using a simulator mannequin. Data were collected between February and May 2023 and the IBM Statistical Package for Social Sciences for Windows (SPSS 25) computer program was used for statistical data analysis. The suitability of the numerical variables for normal distribution was tested by the Shapiro-Wilk test. Since the variables did not conform to the normal distribution, they were given as median (Q1-Q3) values. Participants' preparation, implementation, and total times for ETI and LT were compared using the Wilcoxon test. The duration of face-to-face ETI and LT times were compared regarding participants' personal characteristics, experience status, and the training they received with the Mann-Whitney U test and the Kruskal-Wallis test. Categorical variables are given as number and percentage values. p < 0.05 was considered significant. In face-to-face endotracheal intubation, 24.3% of the participants were successful in the first attempt, 30% in the second attempt, 27.1% in the third attempt, 18.6% failed in all three attempts, and 38.6% performed esophageal intubation. 87.1% of the participants were successful in face-to-face laryngeal tube insertion in the first and 12.9% in the second attempt. The duration of face-to-face laryngeal tube placement was found to be significantly shorter than the duration of endotracheal intubation (p < 0.05). In face-to-face airway conduct, the length of endotracheal intubation time and the high risk of esophageal intubation make the laryngeal tube more advantageous than endotracheal intubation. Furthermore, the high number of attempts required for successful face-to-face endotracheal intubation may pose additional risks by causing destabilization in trauma patients requiring cervical stabilization.