NewB for newbies: a randomized control trial training housestaff to perform neonatal intubation with direct and videolaryngoscopy
| Autor: | Margarita M. Vasquez, Lindsey Koele-Schmidt |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Randomization medicine.medical_treatment education Laryngoscopy Video Recording Psychological intervention Endotracheal intubation Laryngoscopes Manikins law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Anesthesiology law 030225 pediatrics Health science Intubation Intratracheal Humans Medicine Intubation Computer Simulation 030212 general & internal medicine medicine.diagnostic_test business.industry Infant Newborn Internship and Residency Anesthesiology and Pain Medicine Anesthesia Pediatrics Perinatology and Child Health Physical therapy Clinical Competence business |
| Zdroj: | Pediatric Anesthesia. 26:392-398 |
| ISSN: | 1155-5645 |
| Popis: | Summary Background Competency rates in neonatal intubation among pediatric residents are low and currently not meeting ACGME/AAP standards. Aims The aim of this study was to compare standard bedside teaching of neonatal endotracheal intubation to a computer module, as well as introduce residents to the emerging technology of videolaryngoscopy. Methods The study population consisted of The University of Texas Health Science Center at San Antonio Pediatric interns/residents and PGY-1 Anesthesia interns rotating through the NICU. Prior to participating in the study, the residents completed a survey addressing past experiences with intubation, comfort level, and prior use of direct and videolaryngoscopy. Participants then performed timed trials of both direct and videolaryngoscopy on the SimNewB®. They had up to three attempts to successfully intubate, with up to 30 s on each attempt. After randomization, participants received one of the following teaching interventions: standard, computer module, or both. This was followed by a second intubation trial and survey completion. Results Thirty residents were enrolled in the study. There was significant improvement in time to successful intubation in both methods after any teaching intervention (direct 22.0 ± 13.4 s vs 14.7 ± 5.9 s, P = 0.002 and videolaryngoscopy 42.2 ± 29.3 s vs 26.8 ± 18.6 s, P = 0.003). No differences were found between the types of teaching. Residents were faster at intubating with direct laryngoscopy compared to videolaryngoscopy before and after teaching. By the end of the study, only 33% of residents preferred using videolaryngoscopy over direct laryngoscopy, but 76% felt videolaryngoscopy was better to teach intubation. Conclusions Both standard teaching and computer module teaching of neonatal intubation on a mannequin model results in improved time to successful intubation and overall improved resident confidence with intubation equipment and technique. Although intubation times were lower with direct laryngoscopy compared to videolaryngoscopy, the participating residents felt that videolaryngoscopy is an important educational tool. |
| Databáze: | OpenAIRE |
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