The comparison of flex-tip – maleable tip intubation stylet and standard bougie intubation stylet during endotracheal intubation using Macintosh laryngoscope performed by paramedics: a cross-over manikin study

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Aim: Tracheal intubation is generally considered to be an optimal method of protection of airway. Main goal of this study is the evaluation of effectiveness of intubation with the use of new type flex-tip – maleable tip intubation stylet, performed by paramedics. Materials and methods: 158 paramedics participated in the research. After ethics committee approval intubations were performed on manikin model designed for training of endotracheal intubation. Participants trained use of studied device before study. The time needed for first pass successful intubation and possible complications were recorded. Results: Intubation effectiveness with use of flex-tip intubation stylet was higher than the standard bougie: 67.7% (107/158 of successful first pass intuba¬tions) vs. 57% efficiency (91/158) when bougie was used with no statistical significance (p>0.05). However, the number of successful intubation performed within 30 seconds was 93/107 (87%) vs. 53/91 (58%) attempts for flex-tip and standard bougie intubation stylet respectively with statistical significance. Average time of first pass successful intubation with use of flex-tip intubation stylet was slightly shorter than intubation time when bougie was used: 27.3 ± 11.8 s vs. 29.1 ± 12.5 s in flex-tip and bougie intubation stylet respectively with statistical significance. No complications were observed. Conclusions: The effectiveness is higher within recommende 30 sec time of intubation and the intubation time is slightly shorter when flex-tip intubation stylet is used comparing to standard intubation bougie.