Comparing Bougie Versus Endotracheal Tube Alone for First-Attempt Success in Emergency Prehospital Intubation in Adults Without Difficult Airway Predictors

What this Trial Is About

Researchers are studying emergency intubation in patients with acute respiratory failure who need airway management before reaching the hospital. The study aims to compare the success of the first intubation attempt using a bougie device versus using an endotracheal tube alone in the prehospital setting, where challenges like difficult environment and risk of complications are higher. The trial involves two groups one where the first intubation attempt is done with an endotracheal tube plus a bougie, a flexible device to guide the tube, and the other using the endotracheal tube alone. The bougie is inserted first under visual guidance, followed by the tube, while the tube-alone group inserts the tube directly. The use of stylets is not allowed. This comparison helps evaluate the devices impact on success and safety during emergency intubation. Participants will be managed by physician-staffed mobile intensive care units and monitored for success of the first pass intubation within 10 minutes of blade introduction. Additional assessments include monitoring for complications like low oxygen levels, heart rate changes, cardiac arrest, aspiration, and other adverse events within hours after intubation. The time to confirm correct tube placement, perceived difficulty, and injuries or complications up to 48 hours later are also tracked to evaluate safety and effectiveness.

Bougie Versus Endotracheal Tube Alone on First-attempt Intubation Success in Prehospital Emergency Intubation (BETA Trial)