title: Intubation methods by novice intubators in a manikin model.
abstract: Tracheal Intubation is an important yet difficult skill to learn with many possible methods and techniques. Direct laryngoscopy is the standard method of tracheal intubation, but several instruments have been shown to be less difficult and have better performance characteristics than the traditional direct method. We compared 4 different intubation methods performed by novice intubators on manikins: conventional direct laryngoscopy, video laryngoscopy, Airtraq® laryngoscopy, and fiberoptic laryngoscopy. In addition, we attempted to find a correlation between playing videogames and intubation times in novice intubators. Video laryngoscopy had the best results for both our normal and difficult airway (cervical spine immobilization) manikin scenarios. When video was compared to direct in the normal airway scenario, it had a significantly higher success rate (100% vs 83% P=.02) and shorter intubation times (29.1 ± 27.4 sec vs 45.9 ± 39.5 sec, P=.03). In the difficult airway scenario video laryngoscopy maintained a significantly higher success rate (91% vs 71% P=0.04) and likelihood of success (3.2 ± 1.0 95%CI [2.9-3.5] vs 2.4 ± 0.9 95%CI [2.1-2.7]) when compared to direct laryngoscopy. Participants also reported significantly higher rates of self-confidence (3.5 ± 0.6 95%CI [3.3-3.7]) and ease of use (1.5 ± 0.7 95%CI [1.3-1.8]) with video laryngoscopy compared to all other methods. We found no correlation between videogame playing and intubation methods.
authors.affiliation: John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (all authors).
authors.forename: Darragh C
authors.initials: DC
authors.lastname: O'Carroll
authors.forename: Robert L
authors.initials: RL
authors.lastname: Barnes
authors.forename: Ashley K
authors.initials: AK
authors.lastname: Aratani
authors.forename: Dane C
authors.initials: DC
authors.lastname: Lee
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Lau
authors.forename: Paul N
authors.initials: PN
authors.lastname: Morton
authors.forename: Loren G
authors.initials: LG
authors.lastname: Yamamoto
authors.forename: Benjamin W
authors.initials: BW
authors.lastname: Berg
mesh_terms: D002983:Clinical Competence; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007828:Laryngoscopy / Q000379:methods; D008348:Manikins; D013997:Time Factors; D018910:Video Games