Chapter 4 Results

164 participants took part in SATIATED, with an equal number in groups AAB and ABB. The groups were similar with respect to intubation attempts (successful or not) undertaken in the previous 12 months. The median number of years as a paramedic was 1.5 years less in group ABB, although the interquartile range was similar. 36 participants had heard of the SALAD technique prior to the study, with a slightly higher number in group ABB (Table 4.1).

Table 4.1: Summary details of participants

Measure	AAB	ABB	Total
n	82	82	164
Median intubation attempts in past 12 months (IQR)	2.5 (0-6)	3.0 (1-7)	3.0 (1-6.5)
Median number of successful intubation attempts in past 12 months (IQR)	2 (0-5)	2 (0-6)	2 (0-6)
Median years as paramedic (IQR)	5.0 (1-10)	3.5 (0-10)	4.0 (1-10)
Familiar with SALAD technique	15	21	36

First-pass intubation success with and without SALAD on the second attempt, was 53.7% vs 90.2% respectively, a significant difference of 36.6% (95%CI 24–49.1%, p<0.0001). Figure 4.1 summarises the intubation attempt times by participants in each randomisation group. For successful intubation attempts, group ABB was generally faster, except on attempt 2, where AAB intubated sooner (Table 4.2.

Figure 4.1: Intubation attempt times, stratified by randomisation sequence and attempt

Table 4.2: Summary data of the differences between successful intubation attempts

	Attempt 1		Attempt 2		Attempt 3
Measure	AAB	ABB	AAB	ABB	AAB	ABB
Successful attempts n (%)	29 (35.4)	31 (37.8)	44 (53.7)	74 (90.2)	71 (86.6)	73 (89)
Median elapsed time to intubation attempt secs (IQR)	7 (4–13)	6 (3–11)	4 (2–8.5)	4 (2–6)	4 (2–5.5)	3 (2–5)
Median intubation attempt time secs (IQR)	54 (46–61)	50 (40.5–58.5)	40.5 (32.5–57.5)	44 (39–53)	47 (40–54)	41 (35–50)
Median total attempt time secs (IQR)	63 (52–74)	59 (48.5–70.5)	49 (37.5–61.5)	47.5 (43–58)	51 (43.5–58)	44 (38–52)

4.1 Mean difference in time to successful intubation

To determine the mean difference in time to successful intubation, a subset of the data comprised of participants who were successful in intubating on attempts 1 and 2, and attempts 1 and 3, was examined. There was a statistically significant difference between groups AAB (n=23) and ABB (n=28) with respect to the mean difference in time taken to perform a successful intubation on attempts 1 and 2 (mean difference 11.71 seconds, 95% CI 1.95–21.47 seconds, p=0.02). There was no significant difference between groups AAB (n=27) and ABB (n=27) with respect to mean difference in time taken to perform a successful intubation on attempts 1 and 3 (mean difference -2.52 seconds, 95% CI -11.64–6.61 seconds, p=0.58)). Summary values for the mean differences are shown in Table 4.3. Finally, there was no significant difference in success rates on the third attempt between AAB and ABB 89% vs 86.6% respectively, a difference of 2.4% (95%CI 7.6–12.4%, p=0.63).

Table 4.3: Summary data of successful intubation attempts

group	n	mean difference (secs)	standard deviation (secs)	standard error (secs)	95% CI
Attempts 1 and 2
AAB	23	15.4	16.7	3.5	8.2–22.6
ABB	28	3.7	17.9	3.4	-3.3–10.6
Attempts 1 and 3
AAB	27	6.0	20.4	3.9	-2.1–14.1
ABB	27	8.5	11.5	2.2	4–13.1
Note:
In order to be included in this table, both attempts had to be successful.

4.2 Technique

A number of techniques were utilised by participants to facillitate intubation (Figure 4.2). This included asking the assistant to hold the suction catheter in the mouth (n=35), and leaving with the suction in the mouth (although without occluding the suction vent hole, n=20). In addition, there were also instances where participants did not use a bougie (n=48, of which 21 were successful attempts, and 27 unsucessful) and forgot to occlude the suction vent hole on the catheter when attempting to clear the airway themselves (n=35).

Figure 4.2: Bar chart showing techniques and omissions during intubation attempts, stratified by randomisation group, attempt number and intubation outcome