Is digital intubation an option for emergency physicians in definitive airway management?
OBJECTIVE
This study was designed to determine whether digital intubation is a valid option for definitive airway control by emergency physicians.


METHODS
Digital intubation was performed by 18 emergency medicine residents and 4 staff emergency medicine physicians on 6 different cadavers. Placement was confirmed by direct laryngoscopy. The total time for all attempts used, as well as the number of attempts, was recorded. Each participant attempted intubation on all 6 cadavers.


RESULTS
For 5 of the 6 cadavers, successful intubation occurred 90.9% of the time (confidence interval [CI], 85.5%-96.3%) for all participants. The average number of attempts for these 5 cadavers was 1.5 (CI, 1.4-1.7), and the average time required for success or failure was 20.8 seconds (CI, 16.9-24.8). The sixth cadaver developed soft tissue damage and a false passage near the vocal cords resulting in multiple failed attempts.


CONCLUSIONS
Although the gold standard for routine endotracheal intubation remains to be direct laryngoscopy, its effectiveness in certain situations may be limited. We believe that digital intubation provides emergency physicians with another option in securing the unprotected airway.
Young
Scott E
SE
Darnall Army Community Hospital, Fort Hood, TX 76544, USA. sy_ag98@hotmail.com
Miller
Michael A
MA
Crystal
Chad S
CS
Skinner
Carl
C
Coon
Troy P
TP
D000368:Aged; D002102:Cadaver; D002983:Clinical Competence; D004635:Emergency Medicine / Q000193:education*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007828:Laryngoscopy; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies