Research Article Comparison of Different Intubation Methods in Difficult Airways during Simulated Cardiopulmonary Resuscitation with Continuous Chest Compression: A Randomized Cross-Over Manikin Trial Togay Evrin , 1 Jacek Smereka , 2 Damian Gorczyca, 3 Szymon Bialka, 4 Jerzy Robert Ladny, 5 Burak Katipoglu , 1 and Lukasz Szarpak 3 1 Department of Emergency Medicine, Ufuk University Medical Faculty, Dr Ridvan Ege Education and Research Hospital, 06520 Cankaya, Ankara, Turkey 2 Department of Emergency Medical Service, Wroclaw Medical University, Parkowa 34, Wroclaw, Poland 3 Medical Simulation Center, Lazarski University, Swieradowska 43, 02-662 Warsaw, Poland 4 Department of Anaesthesiology and Intensive Care, Medical University of Silesia, 3-go Maja 13-15, 41-800 Zabrze, Poland 5 Department of Emergency Medicine and Disaster, Medical University Bialystok, Szpitalna 37, 15-295 Bialystok, Poland Correspondence should be addressed to Jacek Smereka; jacek.smereka@umed.wroc.pl Received 12 May 2019; Accepted 9 July 2019; Published 20 August 2019 Academic Editor: Jefrey R. Avner Copyright © 2019 Togay Evrin et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. Airway management is one of key elements of resuscitation. Endotracheal intubation is still considered the gold standard for airway management during resuscitation. Aim. Te aim of the study was to compare success rates and intubation time of diferent endotracheal intubation methods during emergency intubation with difcult airways in the conditions of cardiopulmonary resuscitation in a standardized manikin model. Methods. Te study was designed as a prospective, randomized, cross-over simulation study. It involved 46 paramedics with at least 5 years of experience in Emergency Medical Service. Te participants performed endotracheal intubation under difcult airway conditions during continuous chest compression, implemented with the LUCAS3 chest compression system. Tree methods of tracheal intubation were applied: (1) standard Macintosh laryngoscope without a bougie stylet; (2) standard laryngoscope and a standard bougie stylet; (3) standard laryngoscope and a new bougie stylet. Results. Te overall intubation success rate was 100% in the standard bougie and new bougie groups and lower (86.9%) when no bougie stylet was used (P=0.028). Te intubation success rate with the 1 st attempt equalled 91.3% for the new bougie group, 73.9% for standard bougie, and only 23.9% in the no-bougie group. Te median intubation time was shortest in the new bougie group, where it amounted to 29 s (interquartile range [IQR]: 25–38); the time equalled 38s (IQR:31–44.5) in the standard bougie group and 47.5s (IQR:36–58) in the no-bougie group. Te ease of use was lowest in the no-bougie group (85, IQR:63–88), average in the standard bougie group (44, IQR:30–51), and highest in the new bougie stylet group (32, IQR:19–41). Conclusion. In this manikin-based study, paramedics were able to perform endotracheal intubation with higher efcacy and in a shorter time using the new bougie stylet as compared with the standard bougie stylet. 1. Introduction Te European Resuscitation Council (ERC) guidelines rec- ommend endotracheal intubation as the most reliable airway management [1–3]. Te advantages of endotracheal intuba- tion comprise isolation of the airway from the oesophagus, dramatic reduction of the risk of aspiration, reliability of ventilation, possibility of performing airway suctioning with secretion removal, and lack of signifcant leaks at excessive pressures generated during chest compression and disadvan- tages include in particular hyperventilation and excessive infation [4–6]. Tere are a number of limitations and problems related to endotracheal intubation [1, 7]. Te main issue is the need Hindawi Emergency Medicine International Volume 2019, Article ID 7306204, 7 pages https://doi.org/10.1155/2019/7306204