Endotracheal intubation skills of medical students.
The ability and confidence of clinical medical students to insert endotracheal tubes correctly and quickly and to recognize oesophageal misplacement was evaluated. Ten (33%) of the medical students intubated the trachea correctly at their first attempt but 14 (47%) incorrectly identified the position of the endotracheal tube. However, recognition improved by their second and third attempts (70% and 80% respectively). Ninety-three percent of students intubated correctly on their third attempt. Although medical students can obtain better results at correct tube placement with repeated attempts under optimum conditions--a practice effect--and do better at recognizing correct tube placement there is still a persistent failure to recognize endotracheal tube misplacement, ie oesophageal intubation. It is the ability to recognize oesophageal intubation promptly that is a life-saving skill. This essential skill should be taught during the introductory anaesthesia programme through the use of clinical patients.
O'Flaherty
D
D
Department of Anaesthetics, United Medical School, Guy's Hospital, London.
Adams
A P
AP
D000293:Adolescent; D000328:Adult; D000368:Aged; D002983:Clinical Competence / Q000592:standards*; D004501:Education, Medical; D005246:Feedback; D006801:Humans; D007442:Intubation, Intratracheal / Q000592:standards*; D008297:Male; D008875:Middle Aged; D013337:Students, Medical; D013663:Teaching / Q000379:methods