Abstract
Objective
To evaluate the intubation success rates of residents who receive coaching from supervisors concurrently viewing infants’ airways via video during direct laryngoscopy (VDL), as compared with coaching during traditional direct laryngoscopy without video (TDL).
Study design
In a randomized controlled trial, 48 first and second-year residents performed neonatal intubations using VDL or TDL. The primary outcome was intubation success rates. Data were analyzed using the Pearson X2 and Student’s t-test.
Results
The overall intubation success rate was greater in the VDL vs. TDL group (57% vs. 33%, P < 0.05). First-year residents and residents intubating their first patient had higher intubation success rates in the VDL vs. TDL group (58% vs. 23% and 50% vs. 17%, respectively, P < 0.05).
Conclusions
Resident coaching using VDL improved neonatal intubation success rates. Incorporating VDL as a coaching tool can optimize the quality of training during limited opportunities to achieve procedural competency and improve intubation-related patient outcomes.
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References
Haubner LY, Barry JS, Johnston LC, Soghier L, Tatum PM, Kessler D, et al. Neonatal intubation performance: room for improvement in tertiary neonatal intensive care units. Resuscitation. 2013;84:1359–64.
Kumar P, Denson SE, Mancuso TJ. Premedication for nonemergency endotracheal intubation in the neonate. Pediatrics. 2010;125:608–15.
Accreditation Council for Graduate Medical Education. ACGME Program Requirements for Graduate Medical Education in Pediatrics. 2013. http://www.acgme.org/acgmeweb/tabid/143/ProgramandInstitutionalAccreditation/MedicalSpecialties/Pediatrics.aspx. Accessed 2 June 2016.
Dongara AR, Modi JJ, Nimbalkar SM, Desai RG. Proficiency of residents and fellows in performing neonatal intubation. Indian Pediatr. 2014;51:561–4.
Downes KJ, Narendran V, Meinzen-Derr J, McClanahan S, Akinbi HT. The lost art of intubation: assessing opportunities for residents to perform neonatal intubation. J Perinatol. 2012;32:927–32.
Falck AJ, Escobedo MB, Baillargeon JG, Villard LG, Gunkel JH. Proficiency of pediatric residents in performing neonatal endotracheal intubation. Pediatrics. 2003;112:1242–7.
Gilhooly J, Redden HR, Leonard DT. Competency in neonatal endotracheal intubation: mission impossible? Pediatrics. 2015;135:e1290–1.
Le CN, Garey DM, Leone TA, Goodmar JK, Rich W, Finer NN. Impact of premedication on neonatal intubations by pediatric and neonatal trainees. J Perinatol. 2014;34:458–60.
Leone TA, Rich W, Finer NN. Neonatal intubation: success of pediatric trainees. J Pediatr. 2005;146:638–41.
O’Donnell CP, Kamlin CO, Davis PG, Morley CJ. Endotracheal intubation attempts during neonatal resuscitation: success rates, duration, and adverse effects. Pediatrics. 2006;117:e16–21.
O’Shea JE, Thio M, Kamlin CO, McGrory L, Wong C, John J, et al. Videolaryngoscopy to teach neonatal intubation: a randomized trial. Pediatrics. 2015;136:912–9.
Moussa A, Luangxay Y, Tremblay S, Lavoie J, Aube G, Savoie E, et al. Videolaryngoscope for teaching neonatal endotracheal intubation: a randomized controlled trial. Pediatrics. 2016;137:1–8.
Sun Y, Lu Y, Huang Y, Jiang H. Pediatric video laryngoscope versus direct laryngoscope: a meta-analysis of randomized controlled trials. Paediatr Anaesth. 2014;24:1056–65.
de Oliveira Filho GR. The construction of learning curves for basic skills in anesthetic procedures: an application for the cumulative sum method. Anesth Analg. 2002;95:411–6.
Konrad C, Schupfer G, Wietlisbach M, Gerber H. Learning manual skills in anesthesiology: is there a recommended number of cases for anesthetic procedures? Anesth Analg. 1998;86:635–9.
Mulcaster JT, Mills J, Hung OR, MacQuarrie K, Law JA, Pytka S, et al. Laryngoscopic intubation: learning and performance. Anesthesiology. 2003;98:23–7.
Wyckoff MH, Aziz K, Escobedo MB, Kapadia VS, Kattwinkel J, Perlman JM, et al. Part 13: neonatal resuscitation: 2015 American Heart Association Guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132:S543–60.
Weiss M, Schwarz U, Dillier CM, Gerber AC. Teaching and supervising tracheal intubation in paediatric patients using videolaryngoscopy. Paediatr Anaesth. 2001;11:343–8.
DeMeo SD, Katakam L, Goldberg RN, Tanaka D. Predicting neonatal intubation competency in trainees. Pediatrics. 2015;135:e1229–36.
Bismilla Z, Finan E, McNamara PJ, LeBlanc V, Jefferies A, Whyte H. Failure of pediatric and neonatal trainees to meet Canadian Neonatal Resuscitation Program standards for neonatal intubation. J Perinatol. 2010;30:182–7.
Association AAoPaAH. Neonatal resuscitation textbook. 6th ed. Elk Grove Village, IL, 2011.
Acknowledgements
The authors would like to acknowledge Judith Fonzi, PhD, for providing mentorship of Dr. Volz and this project during her Masters in Health Professions education, and Ronnie Guillet, MD, PhD, for her critical review of this project and manuscript.
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Volz, S., Stevens, T.P. & Dadiz, R. A randomized controlled trial: does coaching using video during direct laryngoscopy improve residents’ success in neonatal intubations?. J Perinatol 38, 1074–1080 (2018). https://doi.org/10.1038/s41372-018-0134-7
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DOI: https://doi.org/10.1038/s41372-018-0134-7
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