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Objective Direct laryngoscopy can be performed using curved or straight blades, and providers usually choose the blade they are most comfortable with. However, curved blades are anecdotally thought of as easier to use than straight blades. We seek to compare intubation success rates of paramedics using curved versus straight blades. Methods Design: retrospective chart review. Setting: hospital-based suburban ALS service with 20,000 annual calls. Subjects: prehospital patients with any direct laryngoscopy intubation attempt over almost 9 years. First attempt and overall success rates were calculated for attempts with curved and straight blades. Differences between the groups were calculated. Results 2299 patients were intubated by direct laryngoscopy. 1865 had attempts with a curved blade, 367 had attempts with a straight blade, and 67 had attempts with both. Baseline characteristics were similar between groups. First attempt success was 86% with a curved blade and 73% with a straight blade: a difference of 13% (95% CI: 9–17). Overall success was 96% with a curved blade and 81% with a straight blade: a difference of 15% (95% CI: 12–18). There was an average of 1.11 intubation attempts per patient with a curved blade and 1.13 attempts per patient with a straight blade (2% difference, 95% CI: −3–7). Conclusions Our study found a significant difference in intubation success rates between laryngoscope blade types. Curved blades had higher first attempt and overall success rates when compared to straight blades. Paramedics should consider selecting a curved blade as their tool of choice to potentially improve intubation success.

Background Several studies have been published in the literature about intubation methods, but little is available on intubation equipment used in this setting. This is the first prehospital comparison of disposable plastic vs disposable stainless steel laryngoscope blades used by paramedics. Study Objective The objective of this study was to compare prehospital intubation success rates on first attempt and overall number of attempts to obtain intubations using disposable plastic laryngoscopes blades vs disposable stainless steel laryngoscope blades. Methods A retrospective prehospital cohort study was conducted during two 3-year periods. Two-way contingency table and χ2 test were conducted to determine if there was a difference between the 2 types of blades. A proportional odds model with calculated 95% confidence interval (CI) and odd ratios were then calculated. Results A total of 2472 paramedic intubations were recorded over the 6-year period. The stainless steel single-use blades had a first attempt success rate of 88.9% vs 78.5% with plastic blades (P = .01; odds ratio, 1.94; 95% CI, 1.17-3.41). The stainless steel single-use laryngoscope blade had a lower number of attempts to successful intubation than the plastic blade (88.8% vs 74.3%, respectively) (P Conclusions In the prehospital setting, stainless steel disposable blades were superior to plastic disposable blades in first attempt and overall number of attempts to intubation. Until further research is done, we recommend use of stainless steel blades for intubations in the prehospital setting by paramedics.