Intubation Intraesophageal
Conditions
Keywords
Teaching, Video Scope, Intubation
Brief summary
The use of the video laryngoscope to teach laryngoscopy will improve the performance of tracheal intubation done by novices because it will allow a shared view of the airway leading to a better feedback from the trainer to the trainee.
Detailed description
A group of 30 fourth year medical students and interns rotating through the department of anesthesiology will be studied. Firstly, a standard lecture will be provided in which the description and importance of laryngoscopy and tracheal intubation will be explained. This will include descriptions of anatomy, relevant equipment and technique of tracheal intubation. Following the lecture , the students will be randomly allocated using sealed envelopes into two groups : a control group ( taught with a standard Macintosh Laryngoscope ) and a study group ( taught with the Airtraq video laryngoscope).Each group will receive a demonstration and verbal instruction on how to perform laryngoscopy and tracheal intubation by their instructor.
Interventions
DEVICEAirtraq
Subjects were taught with the Airtraq video laryngoscope
OTHERControl group, taught with a standard Macintosh laryngoscope
Subjects were taught how to use the Mackintosh blade first
Sponsors
Northwestern University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
Students: Inclusion criteria for the medical student: * Medical student or intern rotating through the anesthesiology department
Exclusion criteria
for the medical student: * Previous attempts of laryngoscopy in humans * Subject who refuses participation Patients: Inclusion Criteria: * Age 18 -75 years of age * ASA PS I, II * Procedure that will require General anesthesia with tracheal intubation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Successful Endotracheal Intubation | 120 seconds | A successful placement of the endotracheal tube as defined by the presence of bilateral breath sounds and positive recording of end tidal carbon dioxide. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to Intubation | 120 seconds | Time to intubation is the time interval of blade insertion until the removal of the laryngoscope. |
Countries
United States
Participant flow
Recruitment details
Medical students and intern trainees with no prior experience in laryngoscopy on clinical rotation in the Department of Anesthesiology were recruited to participate. Written informed consent was obtained from all the study participants.
Pre-assignment details
Trainees received a structured lecture in airway management followed by training in laryngoscopy skills on a mannequin, and required to demonstrate proficiency. Trainees were then randomly assigned to attempt their first two intubations on different patients using either the optical or rigid laryngoscope with a MacIntosh size 3 blade.
Participants by arm
| Arm | Count |
|---|---|
| Rigid Laryngoscope Group Medical students or interns attempting intubation with standard size 3 Macintosh laryngoscope | 15 |
| Video Laryngoscope Group Medical students or interns attempting intubation with Airtraq video laryngoscope | 15 |
| Total | 30 |
Baseline characteristics
| Characteristic | Video Laryngoscope Group | Rigid Laryngoscope Group | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 15 Participants | 15 Participants | 30 Participants |
| Age Continuous | 27.5 years STANDARD_DEVIATION 2 | 28 years STANDARD_DEVIATION 3 | 27.75 years STANDARD_DEVIATION 2.5 |
| Region of Enrollment United States | 15 participants | 15 participants | 30 participants |
| Sex: Female, Male Female | 3 Participants | 4 Participants | 7 Participants |
| Sex: Female, Male Male | 12 Participants | 11 Participants | 23 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 9 / 15 | 1 / 15 |
| serious Total, serious adverse events | 0 / 15 | 0 / 15 |
Outcome results
Primary
Successful Endotracheal Intubation
A successful placement of the endotracheal tube as defined by the presence of bilateral breath sounds and positive recording of end tidal carbon dioxide.
Time frame: 120 seconds
Population: The sample analysis was all of the medical students or interns who consented to participate in this study. All participants data was used for the analysis.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Rigid Laryngoscope Group | Successful Endotracheal Intubation | 33.3 % successful |
| Video Laryngoscope Group | Successful Endotracheal Intubation | 83.3 % successful |
p-value: 0.00199% CI: [0.05, 0.05]t-test, 2 sided
p-value: 0.001t-test, 2 sided
Secondary
Time to Intubation
Time to intubation is the time interval of blade insertion until the removal of the laryngoscope.
Time frame: 120 seconds
Population: The sample analysis was all of the medical students or interns who consented to participate in this study. All participants data was used for the analysis.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Rigid Laryngoscope Group | Time to Intubation | 75 seconds |
| Video Laryngoscope Group | Time to Intubation | 35 seconds |