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Improving pediatric resident laryngoscopy training through the use of a video laryngoscope
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 simul...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7331295/ https://www.ncbi.nlm.nih.gov/pubmed/32851256 http://dx.doi.org/10.1002/ped4.12056 |
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author | Lilitwat, Weerapong McInnes, Andrew Chauhan, Jigar |
author_facet | Lilitwat, Weerapong McInnes, Andrew Chauhan, Jigar |
author_sort | Lilitwat, Weerapong |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7331295 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-73312952020-08-25 Improving pediatric resident laryngoscopy training through the use of a video laryngoscope Lilitwat, Weerapong McInnes, Andrew Chauhan, Jigar Pediatr Investig Original Articles 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. John Wiley and Sons Inc. 2018-10-17 /pmc/articles/PMC7331295/ /pubmed/32851256 http://dx.doi.org/10.1002/ped4.12056 Text en © 2018 Chinese Medical Association. Pediatric Investigation published by John Wiley & Sons Australia, Ltd on behalf of Futang Research Center of Pediatric Development. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Articles Lilitwat, Weerapong McInnes, Andrew Chauhan, Jigar Improving pediatric resident laryngoscopy training through the use of a video laryngoscope |
title | Improving pediatric resident laryngoscopy training through the use of a video laryngoscope |
title_full | Improving pediatric resident laryngoscopy training through the use of a video laryngoscope |
title_fullStr | Improving pediatric resident laryngoscopy training through the use of a video laryngoscope |
title_full_unstemmed | Improving pediatric resident laryngoscopy training through the use of a video laryngoscope |
title_short | Improving pediatric resident laryngoscopy training through the use of a video laryngoscope |
title_sort | improving pediatric resident laryngoscopy training through the use of a video laryngoscope |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7331295/ https://www.ncbi.nlm.nih.gov/pubmed/32851256 http://dx.doi.org/10.1002/ped4.12056 |
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