Evaluation of the success rate of the semi-sitting position compared with the supine position in the emergency intubation of traumatic patients

Abstract

Objectives: Tracheal intubation (TI) is an essential skill for various healthcare providers, including emergency medicine specialists and anesthesiologists. The ramped position has been hypothesized to facilitate TI. In this study, we assessed the success rate of the semi-sitting position compared with the supine position in emergency intubation. Methods: In this double-blind clinical trial, 162 traumatic patients admitted to the emergency department at Al-Zahra Hospital were randomly assigned to three groups. Patients in Group I underwent TI in the supine position. Patients in Group II underwent TI in a semi-sitting position at a 25-degree angle, while Group III underwent TI in a semi-sitting position at a 35-degree angle. The Cormack-Lehane (C-L) grade and the number of intubation attempts were compared among the groups. Results: Our findings showed a significant reduction in the number of intubation attempts in Groups II and III compared to Group I (P < 0.001). However, the semi-sitting positions (Groups II and III) were associated with a higher incidence of Grade III and IV C-L views, indicating poorer glottic visualization (P < 0.01). Conclusions: The semi-sitting (ramped) position improves the success rate of TI by reducing the number of intubation attempts. However, it significantly worsens glottic visualization, which may pose challenges during airway management. Further studies are needed to optimize patient positioning in emergency intubation.