Importance:Opportunities for pediatric residents to perform direct laryngoscopy and tracheal intubation(DLTI)are few and the success rate is low.Objective:We hypothesize that incorporation of video laryngoscope(McGrat...Importance:Opportunities for pediatric residents to perform direct laryngoscopy and tracheal intubation(DLTI)are few and the success rate is low.Objective:We hypothesize that incorporation of video laryngoscope(McGrath MAC)into pediatric residents DLTI simulation course will improve the simulated DLTI success rate.Methods:Residents were given 3 attempts at DLTI:(1)baseline using a conventional laryngoscope(CL);(2)using a video laryngoscope(VL);and(3)again using the CL.Residents were given up to 120 seconds to complete each DLTI attempt.Time to successful DLTI was collected.Residents recorded their best view(larynx,epiglottis,vocal cords)with each DLTI attempt.Results:Prior to the intervention,15/17(88.2%)and 16/17(94.1%)of the participants reported prior exposure to DLTI as'less than 10 total attempts'in simulated and live patients respectively.Seventeen pediatric residents performed 51 DLTI attempts(34 with a CL and 17 with the VL).Success rates for DLTI are as follows:Baseline with CL 11/17(64.7%),VL 12/17(70.6%),and last attempt with CL 13/17(76.5%)(P=0.15).Compared to the baseline,the use of VL resulted in a shorter but non-significant decrease in time to successful DLTI(Mean 34.2 sec[SD,22.0]vs.56.5 sec[SD,40.2];P=0.08).Repeat attempts at DLTI with the CL,however,were significantly shorter than baseline(Mean 20.3 sec[SD,12.8]vs.56.5 sec[SD,40.2];P=0.003).Using the VL,more residents could visualize the vocal cords compared to the baseline(14/17[82.3%]vs.9/17[52.9%];P=0.03).Interpretation:Repeated training is certainly a way to improve successful DLTI.Use of VL as a new teaching method led to greater visualization of the vocal cords,shortening operating time and raising self-confidence.展开更多
文摘Importance:Opportunities for pediatric residents to perform direct laryngoscopy and tracheal intubation(DLTI)are few and the success rate is low.Objective:We hypothesize that incorporation of video laryngoscope(McGrath MAC)into pediatric residents DLTI simulation course will improve the simulated DLTI success rate.Methods:Residents were given 3 attempts at DLTI:(1)baseline using a conventional laryngoscope(CL);(2)using a video laryngoscope(VL);and(3)again using the CL.Residents were given up to 120 seconds to complete each DLTI attempt.Time to successful DLTI was collected.Residents recorded their best view(larynx,epiglottis,vocal cords)with each DLTI attempt.Results:Prior to the intervention,15/17(88.2%)and 16/17(94.1%)of the participants reported prior exposure to DLTI as'less than 10 total attempts'in simulated and live patients respectively.Seventeen pediatric residents performed 51 DLTI attempts(34 with a CL and 17 with the VL).Success rates for DLTI are as follows:Baseline with CL 11/17(64.7%),VL 12/17(70.6%),and last attempt with CL 13/17(76.5%)(P=0.15).Compared to the baseline,the use of VL resulted in a shorter but non-significant decrease in time to successful DLTI(Mean 34.2 sec[SD,22.0]vs.56.5 sec[SD,40.2];P=0.08).Repeat attempts at DLTI with the CL,however,were significantly shorter than baseline(Mean 20.3 sec[SD,12.8]vs.56.5 sec[SD,40.2];P=0.003).Using the VL,more residents could visualize the vocal cords compared to the baseline(14/17[82.3%]vs.9/17[52.9%];P=0.03).Interpretation:Repeated training is certainly a way to improve successful DLTI.Use of VL as a new teaching method led to greater visualization of the vocal cords,shortening operating time and raising self-confidence.
