title: Utility of gum-elastic bougie for tracheal intubation during chest compressions in a manikin: a randomized crossover trial.
abstract: OBJECTIVE
  The utility of the gum-elastic bougie (GEB) as an assistive device for tracheal intubation during chest compressions has not been sufficiently validated. This study aimed to compare the utility of the GEB during chest compressions on an adult manikin.
  
  
  METHODS
  Seventeen novice physicians performed tracheal intubation on an adult manikin using the GEB with or without chest compressions. Intubation success rate, intubation time, subjective difficulty of laryngoscopy, and tube passage through the glottis were measured. P < .05 was considered as significantly different.
  
  
  RESULTS
  All novice physicians successfully secured the airway without chest compression with and without the GEB. In contrast, during chest compressions, 7 failed without the GEB, whereas only 1 failed with the GEB (P = .007). Intubation time was significantly longer with chest compressions regardless of GEB use (P < .001). Both laryngoscopy and tube passage through the glottis were perceived as significantly more difficult with chest compressions, regardless of GEB use (P < .001). Subjective difficulty of tube passage through the glottis during chest compression was perceived as significantly more easy by GEB application (P < .001).
  
  
  CONCLUSIONS
  These findings suggest that the GEB facilitates tracheal intubation during chest compressions performed by novice physicians in adult simulations.
authors.affiliation: Department of Anesthesiology, Osaka Medical College, Japan. Electronic address: ane078@poh.osaka-med.ac.jp.
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Komasawa
authors.affiliation: Department of Anesthesiology, Osaka Medical College, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Cho
authors.affiliation: Department of Anesthesiology, Osaka Medical College, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Mihara
authors.affiliation: Department of Anesthesiology, Osaka Medical College, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Minami
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation*; D002983:Clinical Competence; D018592:Cross-Over Studies; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D007828:Laryngoscopy; D008348:Manikins; D013997:Time Factors