• Attila Aydın, Sedat Bilge, Cemile Aydın, Meltem Bilge, Erdem Çevik, and Mehmet Eryılmaz.
• Department of Emergency Medicine, Gülhane Training and Research Hospital, Ankara-Turkey. drattilaaydin@gmail.com.
• Ulus Travma Acil Cer. 2018 Mar 1; 24 (2): 97-103.

BackgroundEndotracheal intubation (ETI) procedure in the combat area differs from prehospital trauma life support procedures because of the danger of gunfire and the dark environment. We aimed to determine the success, difficulty degree, and duration of ETI procedures with a classical laryngoscope (CL) in a bright room and with a modified laryngoscope (ML) model in a dark room.MethodsAll interventions were performed by a combatant medical staff of 10 members. We developed an ML model to obtain a tool that can be used in combination with night vision goggles (NVGs) to perform ETI at night. The procedures were performed using a CL with the naked eye in a bright room and using a ML with NVGs in a dark room. The ETI procedure that used the ML was performed by engaging and locking the blade on the handle either in the mouth (ML-IM) or outside of the mouth (ML-OM).ResultsThe mean completion times for the ETI procedures, namely Day-CL, ML-OM+NVG, and ML-IM+NVG, performed by the operators were 14.46, 26.9, and 32.38 s, respectively. The ML-OM+NVG and ML-IM+NVG procedures were significantly longer than the Day-CL procedure (p<0.05). The ML-IM+NVG procedure was significantly longer than the ML-OM+NVG procedure (p<0.05). All ETI procedures were found to be 100% successful. The Day-CL procedure was easier than the ML-OM+NVG and ML-IM+NVG procedures (p>0.05).ConclusionThe ETI procedure is applicable using NVGs in dark conditions on the battlefield. Medical interventions performed using NVGs in the dark should be a part of the basic training provided in tactical emergency medicine.

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