Repeated attempts improve tracheal tube insertion time using the intubating laryngeal airway in a mannequin.
OBJECTIVE
To determine if repeated performance of endotracheal tube insertion via the intubating laryngeal airway (ILA) would shorten insertion time in mannequins.


METHODS
Prospective study.


METHODS
Clinical Skills Laboratory, Department of Anesthesia, Toronto Western Hospital.


METHODS
65 department anesthesiologists.


METHODS
After a video training session, anesthesiologists with no previous experience with the ILA performed 5 consecutive ILA-guided tracheal tube intubations on a mannequin. Each participant completed Task 1: insertion of an ILA; Task 2: blind insertion of a tracheal tube through the ILA, and Task 3: removal of the ILA. The time required for each task and the total intubation time for the three tasks over the 5 attempts were recorded. These times were compared using repeated-measures analysis of variance. The success rate among the 5 attempts was compared using Chi-Square analyses.


RESULTS
A total of 65 anesthesiologists performed 5 ILA-guided tracheal intubations each. Total intubation time decreased from the first to the fifth attempt (92.6 ± 22.7 sec, 74.5 ± 19.2 sec, 66.5 ± 16.5 sec, 65.9 ± 19.9 sec, and 60.8 ± 16.3 sec; P < 0.001). Significant differences in intubation times were noted between the first and second, and the second and third attempts (P < 0.001 and P = 0.02, respectively). The success rate did not change over the 5 attempts (84.6%, 89.2%, 84.6%, 89.2%, and 90.8%; P = 0.737).


CONCLUSIONS
Total intubation time decreased by 34% (92.6 to 60.8 sec) over the 5 attempts in mannequins. The success rate ranged from 84.6% to 90.8% and did not differ significantly over the 5 attempts.
Department of Anesthesia, Toronto Western Hospital, University of Toronto, Toronto M5T 2S8, Ontario, Canada. david.wong@uhn.on.ca
David T
DT
Wong
Narisa
N
Apichatibutra
Gagan
G
Arora
Jacqueline A
JA
Woo
Victor Y
VY
Lee
Lakshmi Venkat
LV
Raghavan
D000328:Adult; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D017214:Laryngeal Masks; D008348:Manikins; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors