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Standard use of Gum elastic bougies (GEB) in patients requiring Rapid Sequence Induction (RSI) in the emergency department

Three Part Question

In [patients requiring rapid sequence induction in the Emergency Department] is [the use of gum elastic bougie introducers as standard better than operator choice] at increasing [first pass success rates and reducing adverse events (desaturation)]?

Clinical Scenario

A patient is brought into ED with airway difficulty and stridor and requires intubation. Rapid sequence induction for anaesthesia is performed. On laryngoscopy the view is Cormack Grade 2 and the anaesthetist says they don’t need a bougie to pass the endotracheal tube and intubate the patient. You wonder if the endotracheal tube will be passed first time.

Search Strategy

OVID interface. Medline 2001 – 2016; Embase 2001 – 2016
(bougie*.ti,ab; OR introducer*.ti,ab OR geb.ti,ab) AND ( "intratracheal intubation".ti,ab OR (trachea* adj2 intubat*).ti,ab OR exp *INTUBATION, INTRATRACHEAL/) .
[Limit to: Publication Year 2001-2016 and (Language English) and Humans]; 299 results.
(BOUGIE/OR bougie*.ti,ab OR introducer*.ti,ab OR geb.ti,ab) AND ((trachea* adj2 intubat*).ti,ab OR exp *ENDOTRACHEAL INTUBATION/ OR "intratracheal intubation".ti,ab
[Limit to: Human and English Language and Publication Year 2001-2016]
232 results.
Of the Embase results only 70 were new so total no. of references to review=369.

Search Outcome

369 papers found of which none directly answered the three-part question.