Pilot Study on the Use of Video Laryngoscopy in Pre-hospital Settings
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorCentre Hospitalier de Valenciennes
About this trial
Management of the upper airways is an essential skill in pre-hospital medicine in order to protect the respiratory tract and optimise ventilation and oxygenation. Orotracheal intubation remains the gold standard method in this context. In France, approximately 8% of primary SMUR interventions require intubation, representing 40,000 to 50,000 procedures per year, 30 to 40% of which are performed on patients in cardiorespiratory arrest.
Despite an overall success rate of nearly 99%, 8 to 15% of intubations are considered difficult and the success rate on the first attempt is only 77.8%. Difficult intubations expose patients to significant complications, including desaturation (nearly 50% of cases), haemodynamic disorders and, more rarely, cardiopulmonary arrest (3% of cases). Pre-hospital conditions (environment, access to the patient, trauma, secretions, etc.) increase these risks. As a result, recent recommendations now consider any emergency intubation outside the operating theatre to be potentially difficult.
The introduction of video laryngoscopy represents a major technological advance. Its superiority has been demonstrated in hospital settings, particularly for difficult intubations, and it is now recommended as the first-line treatment in this context. However, unlike in the United States, where several studies suggest that it is safer and more effective than direct laryngoscopy, there are no specific recommendations or French studies concerning its use in pre-hospital medicine.
Given these factors and the lack of national data, it seems appropriate to conduct an exploratory French study to assess the place, effectiveness, benefits and constraints of video laryngoscopy in a pre-hospital setting. Investigator hypothesises that the success rate for the first attempt at intubation using video laryngoscopy will be 74%.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Age > 18 years
Patients treated pre-hospital by a team from the Emergency Medical and Resuscitation Service (SMUR) at Valenciennes Hospital 2025-A02374-45_SUMMARY_v1.1 dated 04/12/2025 _VIDEOPREHOSP Page 3 of 4
Patients whose condition requires pre-hospital orotracheal intubation
Patient or relative who has given consent for inclusion
Disqualifiers
Progressive pregnancy
Theoretical indication for orotracheal intubation but patient refuses invasive care, considered in this situation to be futile medical care
Insurmountable anatomical obstacle, in which case an emergency cricothyroidotomy or tracheotomy should be considered as the first line of treatment
Patients under guardianship or curatorship
Trial design
Design model
Single group
Treatments tested in this trial
Videolaryngoscopy in first attempt in prehospital with AirTraq
DeviceThis is a single-centre study conducted at Valenciennes Hospital. Eligible patients will be those requiring intubation in a life-threatening emergency as part of standard care. During each SMUR intervention, patients will be assessed to determine their eligibility for the study, according to the inclusion and exclusion criteria previously defined in the protocol. This verification will be carried out by the practitioner in charge of pre-hospital care, before the intubation procedure is performed. The clinical data required for this assessment will be collected prospectively.
Treatment groups
143 Participants
are divided into 1 treatment groupGroup A: Experimental armExperimental treatment 1 intervention
Trial outcomes
Primary outcomes
1
The main objective of this exploratory study is to estimate the success rate of the first attempt at pre-hospital video laryngoscopy intubation.
The primary endpoint is the success rate of intubation on the first attempt. The endpoint analysed will be a binary measure (success: 1 / failure: 0) collected during the procedure.
Time frame
immediately after orotracheal intubationSecondary outcomes
1
Secondary objective N°1 : To study the correlation between patient-related constraints in the use of video laryngoscopy and the success/failure of the first intubation attempt.
The aim is therefore to study the main variable (success or failure of intubation on the first attempt) in relation to different variables that have different units of measurement. Constraints encountered during intubation related to the patient: * Mouth opening: \< 2 cm, between 2 and 3.5 cm, \> 3.5 cm * Thyro-mental distance: \< 5 cm, between 5 and 6.5 cm, \> 6.5 cm * Cormack score: I/II, III/IV * Obesity (BMI \> 30): Yes/No * Presence of secretions in the upper airways: Yes/No * Presence of cervical-facial trauma: Yes/No
Time frame
immediately after orotracheal intubation2
Secondary outcome N°2 : To investigate the correlation between the constraints of using video laryngoscopy in an out-of-hospital setting and the success/failure of the first intubation attempt
The aim is therefore to study the main variable (success or failure of intubation on the first attempt) in relation to different variables that have different units of measurement. Constraints encountered during intubation, related to the practitioner: * Years of experience as an emergency physician * Number of successful intubations using video laryngoscopy: \< 15, between 15 and 50, \> 50
Time frame
immediately after orotracheal intubation3
Secondary objective N°3 : To investigate the correlation between the constraints of using video laryngoscopy in an out-of-hospital setting and the success/failure of the first intubation attempt
The aim is therefore to study the main variable (success or failure of intubation on the first attempt) in relation to different variables that have different units of measurement. Constraints encountered during intubation in an out-of-hospital setting: * Patient position: On the ground or on a stretcher * Practitioner position: Lying down, kneeling, or standing * Bright light interfering with visibility on the video laryngoscope: Yes or No
Time frame
Immediately after video laryngoscopySponsors and contacts
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Source ClinicalTrials.gov