Comparison of Gum Elastic Bougie and Macintosh Laryngoscope in Pre-hospital Pediatric Airway Management; A randomized, prospective study

INTRODUCTION: Endotracheal intubation (ETI) in children requires good technique and experience. Gum elastic bougie (GEB) is a practical, inexpensive, easy-to-use airway method in the adult airway. Through GEB, ETI is a method that can be learned after short training. We aimed to evaluate the effectiveness of this method, which has not yet been validated in pediatric patients in prehospital pediatric airway applications.
METHODS: This study was designed as a study simulating the prehospital period with a mankin. Practitioners were asked to perform intubation by conventional intubation or GEB.
RESULTS: This study was performed with 48 emergency medical technicians and paramedics. 4 (8.3%) of the practitioners had experience using GEB. In terms of first-pass success, no difference was found between ETI via GEB and Macintosh blade conventional ETI (91.7% (44/48), 93.8% (45/48), respectively, p = 1.000). Use of GEB increased ETI time (28.6 ± 6.0 sec vs 17.1 ± 4.0 sec, mean df: 11.3 sec (95% CI: 9.7 - 12.8), p <0.001). While 87.6% of the practitioners evaluated the use of GEB as very easy and easy, 83.3% of the practitioners evaluated the traditional method as very easy and easy (p = 0.914).
DISCUSSION AND CONCLUSION: GEB does not make any difference in pediatric airway management in terms of first-pass success. However, the use of GEB in terms of ETI durations increases the duration of ETI. Besides, the use of GEB is seen as a method that can be applied more efficiently, even in inexperienced groups.