Comparison of available gum-elastic bougies.

INTRODUCTION: The purpose of this study was to compare 4 different gum-elastic bougies (GEBs) for differences in success rate, speed of intubation, and device preference.

METHODS: This was a randomized study of 4 different GEBs (Sunmed, Portex, Greenfield, and Eschmann) used by emergency medicine (EM) and anesthesiology residents and attending physicians on a simulated difficult airway model. Success, time to intubation, and personal preference were recorded for each participant. Data were compared with analysis of variance, chi(2) and t tests, and 95% confidence intervals (95% CIs) where appropriate. P < .05 was considered significant.

RESULTS: Twenty-one participants from EM (16 residents, 5 faculty) and 13 from anesthesia (9 residents, 4 faculty) were entered into the study. Overall success rates were 88% for Sunmed, 68% for Portex, 88% for Greenfield, and 79% for Eschmann. Participants were significantly more likely to be successful when using either the Sunmed or the Greenfield GEB compared with the Portex GEB (relative risk [RR] = 1.3, 95% CI = 1.0-15.6). Success rate by specialty was significantly different with 60 (71%) of 84 for EM physicians and 50 (96%) of 52 for anesthesiologists. Speed of intubation was a mean +/- SD of 22.5 +/- 9.7 seconds, with no significant difference by GEB or specialty. Participants were significantly more likely to prefer the Sunmed over the Greenfield (P = .001, RR = 6.9, 95% CI = 1.5-24.8) and the Eschmann over the Greenfield (P = .003, RR = 6.1, 95% CI = 1.6-63.0).

CONCLUSION: Emergency medicine physicians had better success rates using the Sunmed and Greenfield GEBs but low preference for the Greenfield GEB.