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document
Successful difficult intubation . Tracheal tube placement over a gum-elastic bougie . A randomised study was carried out to assess the effect of tracheal tube rotation on the passage of a tube over a gum-elastic bougie into the trachea in 100 patients . The effect of the presence or absence of a laryngoscope on successful tube placement was also assessed . A grade 3 difficult intubation was simulated in patients with a laryngoscope . There was a significant difference in the rates for successful first-time intubation in those patients with tube orientation of -90 degrees ( with the bevel facing posteriorly ) as compared with a tube orientation of 0 degrees ( the normal orientation with the bevel facing left ) . The unsuccessful first-time intubations with a 0 degree orientation were frequently converted to successful intubations with the -90 degrees position at a second attempt . The presence of a laryngoscope in the mouth while rail-roading a tube over the bougie also made a significant difference to the rate of successful first-time intubations . The most successful method was to leave the laryngoscope in the mouth and rotate the tube to -90 degrees .
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Intervention_Physical
intubation
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Intervention_Physical
Tracheal tube placement
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Intervention_Physical
gum-elastic bougie
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Intervention_Physical
tracheal tube rotation
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Intervention_Other
simulated
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Intervention_Pharmacological
laryngoscope
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Intervention_Physical
first-time intubation
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Intervention_Physical
intubations
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Intervention_Other
laryngoscope
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Intervention_Physical
laryngoscope
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Outcome_Other
successful first-time intubation
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Outcome_Other
unsuccessful first-time intubations
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Outcome_Other
successful intubations
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Outcome_Other
presence of a laryngoscope
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Outcome_Other
rate of successful first-time intubations
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Outcome_Other
successful
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Participant_Condition
patients with a laryngoscope .