Neonatal intubation: success of pediatric trainees.
OBJECTIVE
To review the success of pediatric trainees for neonatal intubation over a 10-year interval at a single academic center.


METHODS
We reviewed a database of all neonatal intubations designed as a quality assurance process at our institution. Respiratory care practitioners recorded the number of attempts at the time of each procedure. Attempts were defined as each time a laryngoscope was placed in the baby's mouth. Success rates were calculated as the number of successful intubations divided by the attempts.


RESULTS
From January 1992 through September 2002, 5051 successful intubations with 9190 attempts were performed by all practitioners. Pediatric residents intubated neonates successfully on 1676 occasions requiring 3719 attempts. The median success rates were 33% for pediatric level (PL)1 residents; 40% for PL2 and PL3 residents, and 68% for neonatal fellows ( P < .001). The success rates for residents who had more than 20 total attempts versus those who had fewer than 20 attempts were 49% versus 37% ( P < .001).


CONCLUSIONS
Developing proficiency at intubation requires a significant amount of experience. Current pediatric residents at our institution have inadequate opportunity to achieve consistent success.
Leone
Tina A
TA
Division of Neonatology, San Diego Medical Center, University of California-San Diego, 200 W. Arbor Drive, San Diego, CA 92103, USA.
Rich
Wade
W
Finer
Neil N
NN
D002140:California; D002983:Clinical Competence / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007396:Internship and Residency; D007442:Intubation, Intratracheal; D010372:Pediatrics / Q000193:education*