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Effect of Upright Patient Positioning on Intubation Success

NCT ID: NCT02885298

Last Updated: 2016-08-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

232 participants

Study Classification

OBSERVATIONAL

Study Start Date

2014-07-31

Study Completion Date

2016-07-31

Brief Summary

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Endotracheal intubation is most commonly taught and performed with the patient supine. Recent literature suggests that elevating the patient's head to a more upright position may decrease peri-intubation complications. However, there is little data on success rates of upright intubation in the emergency department. The goal of this study was to measure the association of head positioning with intubation success rates among emergency medicine residents.

Detailed Description

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Endotracheal intubation is most commonly taught and performed with the patient supine. Recent literature suggests that elevating the patient's head to a more upright position may decrease peri-intubation complications. However, there is little data on success rates of upright intubation in the emergency department. The goal of this study was to measure the association of head positioning with intubation success rates among emergency medicine residents. Study design was a prospective observational study. Residents performing intubation recorded the angle of the head of the bed, and the number of attempts required for successful intubation was recorded by faculty and respiratory therapists. The primary outcome of first past success was calculated with respect to three groups: 0-10 degrees (supine), 11-44 degrees (inclined), and ≥45 degrees (upright); first past success was also analyzed in 5 degree angle increments.

Conditions

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Intubation

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Supine intubations (0-10 degrees)

Intubations performed with patient positioned 0-10 degrees. Patient supine.

Upright intubation

Intervention Type PROCEDURE

Upright Intubation procedure performed with patient elevated above the supine position. Defined as upright greater to or equal to 45 degrees or inclined 10-44 degrees

Inclined (11-44 degrees)

Intubations performed with 11-44 degrees of elevation.

Upright intubation

Intervention Type PROCEDURE

Upright Intubation procedure performed with patient elevated above the supine position. Defined as upright greater to or equal to 45 degrees or inclined 10-44 degrees

Upright (45 degrees or greater)

intubations performed with patient elevated to 45 degrees or greater

Upright intubation

Intervention Type PROCEDURE

Upright Intubation procedure performed with patient elevated above the supine position. Defined as upright greater to or equal to 45 degrees or inclined 10-44 degrees

Interventions

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Upright intubation

Upright Intubation procedure performed with patient elevated above the supine position. Defined as upright greater to or equal to 45 degrees or inclined 10-44 degrees

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Adult medical intubations in which the intubating resident and supervising faculty both consented to study participation.

Exclusion Criteria

* Pediatric patients
* Obstetric patients
* Trauma patients
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Indiana University

OTHER

Sponsor Role lead

Responsible Party

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Joseph Turner

Assistant Professor of Clinical Emergency Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Joseph Turner, MD

Role: PRINCIPAL_INVESTIGATOR

Indiana University

References

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Reference Type BACKGROUND
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Khandelwal N, Khorsand S, Mitchell SH, Joffe AM. Head-Elevated Patient Positioning Decreases Complications of Emergent Tracheal Intubation in the Ward and Intensive Care Unit. Anesth Analg. 2016 Apr;122(4):1101-7. doi: 10.1213/ANE.0000000000001184.

Reference Type BACKGROUND
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Reference Type BACKGROUND
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Dixon BJ, Dixon JB, Carden JR, Burn AJ, Schachter LM, Playfair JM, Laurie CP, O'Brien PE. Preoxygenation is more effective in the 25 degrees head-up position than in the supine position in severely obese patients: a randomized controlled study. Anesthesiology. 2005 Jun;102(6):1110-5; discussion 5A. doi: 10.1097/00000542-200506000-00009.

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Reference Type BACKGROUND
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Study Documents

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Document Type: Study Protocol

View Document

Other Identifiers

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1405954059

Identifier Type: -

Identifier Source: org_study_id