Effectiveness of the Use of a Pillow for Endotracheal Intubation in Adult Patients and the Satisfaction of Clinical Staff

Abstract

The objectives of this study were to assess the effecitveness of a pillow in assisting endotracheal intubation and to evaluate the satisfaction of physicians and nurses on the use of the pillow. It was conducted as a randomized controlled trial in Yasothorn hospital using 2 sizes of pillow, 5 and 7 cm hight. The study samples were 300 patients requiring endotracheal intubation. They were randomly assigned into 3 groups, 100 each: group 1 patients were intubated by 5 cm pillow, group 2 by 7 cm pillow, and group 3 as control - intubated without using a pillow. The pillows were specifically produced in a curve form to fit the contour shape of the head. The effectiveness of the pillow was assessed by the capability to produce laryngeal view and the success of intubation among the 3 groups. Opinions on the pillow use were assessed by direct interview with each clinical staff (anesthetists, first year physicians, and emergency medical service [EMS] nurses) on their satisfaction and concerns. It was found that the laryngeal view and intubation success were not significantly different between the group 1 and 2, but were significantly better than the control (group 3) (p<0.05). Regarding the satisfaction, 90.0% of anesthetists, 70.0% of physicians, and 100.0% of EMS nurses was satisfied with the 5 cm pillow because it could help to perform successful intubation. All clinical staff agreed that the pillow would be useful in fixing the patient’ head in awake intubation. It was also observed that request for anesthesiologists and nurse anesthetists to assist the intubation outside operating room had significantly declined in the year 2017 compared to that of 2016 when the pillow was not in use.