Can Intubation Be Improved with Endotracheal Tubes Marked with a Color Scale? Randomized Controlled Study

Area of Science:

• Medical Devices
• Emergency Medicine
• Pediatric Critical Care

Background:

• Endotracheal intubation is a critical procedure in emergency medicine.
• Accurate selection of endotracheal tube (ETT) size and depth is crucial for patient safety.
• Current methods using numeric scales may present challenges in rapid, accurate ETT placement.

Purpose of the Study:

• To evaluate the efficacy of a novel color scale on endotracheal tubes (ETTs) compared to traditional numeric scales.
• To determine if the color scale improves the accuracy of ETT size selection and depth of placement.
• To assess the impact of the color scale on the time required for endotracheal intubation procedures.

Main Methods:

• A multi-center study involving 108 operators performing 432 intubations on a mannequin model.
• Experimental ETTs featured a color scale, with each size identified by a distinct color.
• Operators were trained on the use of the experimental ETTs and performed intubations based on birth weight in four randomized clinical scenarios.

Main Results:

• No significant difference was observed in the correct selection and placement of the ETT between the numeric and color scales.
• The median intubation time was significantly reduced when using the experimental color-scaled ETTs across various sizes (p < 0.001 to p = 0.019).
• Specific time reductions were noted for ETT sizes including Neonatal Resuscitation Program (NRP) 2.5, 3, 3.5, and 4.

Conclusions:

• The color-scaled ETT did not improve the accuracy of tube selection or placement.
• The experimental ETT significantly decreased the time required for endotracheal intubation.
• This color-coding intervention shows potential to enhance intubation effectiveness by reducing procedure time.