Evaluation of IntuBrite® laryngoscope for endotracheal intubation performed by paramedics in out-of-hospital cardiac arrest with particular insight on patients with obesity - A randomised control study

Background: Airway management next to the high -quality chest compressions and early defibrillation is one of the most important procedures performed by paramedics during cardiopulmonary resuscitation (CPR) in out -ofhospital cardiac arrest (OHCA). The aim of the presented study was to assess the time and effectiveness of endotracheal intubation performed by a paramedics during OHCA with the use of a classic Macintosh laryngoscope (MCL) and an IntuBrite laryngoscope (IBL). Methods: A total of 60 adult patients were qualified for the study. The tested laryngoscopes were evaluated in terms of the effectiveness and time of procedure, the degree of difficulty of intubation attempts and individual patient factors, with particular emphasis on obesity, which may negatively affect the intubation performance in pre -hospital care. Results: The overall number of successful intubations with the IBL was 30 (100 %), and with a MCL 20 (66,67 %). Efficiency of first intubation attempt (FIA) using, the IBL was 86,67 % (n = 26/30) while for the MCL it was 66,67 % (n = 20/30). During second attempt, 100 % of patients were intubated with the IBL and none with the MCL. The median time to first intubation (IT) was 18,12 s for the IBL and 19,86 s for the MCL. Non -obese patients were more effectively intubated than those with obesity (94,4 % vs 66,67 %, p = 0.01). Conclusions: FIA success of patients with OHCA using the IBL was significantly higher than the MCL (p = 0.0008), for both in the first and in the total number of intubation attempts. There were no statistically significant differences in the time of intubation between individual laryngoscopes. Non -obese patients were significantly more effectively intubated during CPR than obese patients (p = 0.01).