• The Korean Journal of Emergency Medical Services
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• v.23 no.3
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• pp.111-121
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• 2019

Purpose: Difficult organs or locations or inadequate tube intubations can cause complications. There are some cases in which the tube location changes or the tube is removed due to processing inside the organ while installing the stylet or rapid stylet removal. Thus, this study aimed to evaluate and develop an integrated intubation tube with stylet (IITS) for easier intubation of organs in emergency cases and reduce complications caused by the stylet. Methods: This study used a "Laerdal Airway Management Trainer". For stylet intubation, procedure No. 14 of the national practical test protocol was followed, but the removal step was omitted. In this study, each emergency case was intubated with an IITS, in which the stylet was not inserted or removed separately even though it has the function of an organ intubation stylet. Results: The existing classic ET intubation method had a success rate of 100% and had an average intubation time of 21.75 seconds, The developed IITS method was also successful in all cases and had an average intubation time of 15.78 seconds. Conclusion: Application of an IITS is expected to reduce intubation time and decrease inappropriate depth and intubation failure due to stylet removal, therefore improving the efficiency of airway maintenance.

• The Korean Journal of Emergency Medical Services
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• v.24 no.2
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• pp.123-131
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• 2020

Purpose: This study aimed to find out the effectiveness of gum elastic bougies for intubation in comparison to stylet according to airway type using a manikin. Methods: The study subjects were 52 paramedic students who intubated using a Macintosh laryngoscope and compared stylet and gum elastic bougie use in a 7.5 mmID endotracheal tube, on a manikin with either normal or difficult airway. Difficult airway was made Philadelphia neck collar. Collected data included intubation time, accuracy and ease of intubation, later analyzed by frequency analysis, descriptive analysis, independent t-test, chi square test, paired t-test, and McNemar test using SPSS Statistics 18.0. Results: There was a significant difference in intubation time according to intubation device and airway type (p=.000). There was no significant difference in accuracy of intubation according to intubation device or airway type (normal airway p=1.000, difficult airway p=.052). There was a significant difference in ease of intubation scale according to intubation device and airway type (p=.000, p=.000). Conclusion: Based on the speed and ease of intubation, gum elastic bougie is recommended for intubation in patients with difficult airways such as those with cervical injury.

• Journal of Yeungnam Medical Science
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• v.24 no.2
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• pp.344-350
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• 2007

Laryngo-tracheal perforation caused by the use of a stylet during tracheal intubation is a rare complication. We present a case of subcutaneous emphysema and connective tissue inflammation after tracheal intubation. The patient was a 41-year-old male undergoing general anesthesia for an appendectomy. The intubation was difficult during laryngoscopy (Cormack- Lehane Grade III). An assistant provided an endotracheal tube with a stylet inside while the laryngoscope was in place. During intubation, a short, dull sound was heard with a sudden loss of resistance after the distal tip of the endotracheal tube passed the rima glottis. A sonogram and computerized tomography revealed subcutaneous emphysema from the neck to the upper mediastinum and fluid collection between the trachea and the thyroid. This lesion appeared to have been caused by the protruded, loose stylet. Anesthesiologists should be aware of the damage a loose stylet protruding beyond the tip of the endotracheal tube can cause.