CC BY-NC-ND 4.0 · AJP Rep 2020; 10(01): e5-e10
DOI: 10.1055/s-0039-3400970
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Is Video Laryngoscopy the Optimal Tool for Successful Intubation in a Neonatal Simulation Setting? A Single-Center Experience

1   Division of Neonatology, Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
,
Sibasis Daspal
1   Division of Neonatology, Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
,
John Shatzer
2   Johns Hopkins University School of Education, Baltimore, Maryland
› Author Affiliations
Further Information

Publication History

01 May 2019

13 August 2019

Publication Date:
27 January 2020 (online)

Abstract

Background Endotracheal intubation is a skill required for resuscitation. Due to various reasons, intubation opportunities are decreasing for health care providers.

Objective To compare the success rate of video laryngoscopy (VL) and direct laryngoscopy (DL) for interprofessional neonatal intubation skills in a simulated setting.

Methods This was a prospective nonrandomized simulation crossover trial. Twenty-six participants were divided into three groups based on their frequency of intubation. Group 1 included pediatric residents; group 2 respiratory therapists and transport nurses; and group 3 neonatal nurse practitioners and physicians working in neonatology. We compared intubation success rate, intubation time, and laryngoscope preference.

Results Success rates were 100% for both DL and VL in groups 1 and 2, and 88.9% for DL and 100% for VL in group 3. Median intubation times for DL and VL were 22 seconds (interquartile range [IQR] 14.3–22.8 seconds) and 12.5 seconds (IQR 10.3–38.8 seconds) in group 1 (p = 0.779); 17 seconds (IQR 8–21 seconds) and 12 seconds (IQR 9–16.5 seconds) in group 2 (p = 0.476); and 11 seconds (IQR 7.5–15.5 seconds) and 15 seconds (IQR 11.5–36 seconds) in group 3 (p = 0.024).

Conclusion We conclude that novice providers tend to perform better with VL, while more experienced providers perform better with DL. In this era of decreased clinical training opportunities, VL may serve as a useful tool to teach residents and other novice health care providers.

 
  • References

  • 1 Papile L-A, Baley JE, Benitz W. , et al; Committee on Fetus and Newborn; American Academy of Pediatrics. Respiratory support in preterm infants at birth. Pediatrics 2014; 133 (01) 171-174
  • 2 Niermeyer S, Kattwinkel J, Van Reempts P. , et al. International Guidelines for Neonatal Resuscitation: an excerpt from the Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: International Consensus on Science. Contributors and Reviewers for the Neonatal Resuscitation Guidelines. Pediatrics 2000; 106 (03) E29-E29
  • 3 Wyckoff MH, Aziz K, Escobedo MB. , et al. Part 13: neonatal resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015; 132 (18) (Suppl. 02) S543-S560
  • 4 Leone TA, Rich W, Finer NN. Neonatal intubation: success of pediatric trainees. J Pediatr 2005; 146 (05) 638-641
  • 5 Goto T, Gibo K, Hagiwara Y. , et al; Japanese Emergency Medicine Network Investigators. Multiple failed intubation attempts are associated with decreased success rates on the first rescue intubation in the emergency department: a retrospective analysis of multicentre observational data. Scand J Trauma Resusc Emerg Med 2015; 23 (01) 5
  • 6 Sanders Jr RC, Giuliano Jr JS, Sullivan JE. , et al; National Emergency Airway Registry for Children Investigators and Pediatric Acute Lung Injury and Sepsis Investigators Network. Level of trainee and tracheal intubation outcomes. Pediatrics 2013; 131 (03) e821-e828
  • 7 Nishisaki A, Scrattish L, Boulet J. , et al. Effect of recent refresher training on in situ simulated pediatric tracheal intubation psychomotor skill performance. In: Henriksen K, Battles JB, Keyes MA. , et al, eds. Advances in Patient Safety: New Directions and Alternative Approaches. Vol. 3. Rockville, MD: Agency for Healthcare Research and Quality (US); 2008
  • 8 Augustine EM, Kahana M. Effect of procedure simulation workshops on resident procedural confidence and competence. J Grad Med Educ 2012; 4 (04) 479-485
  • 9 Healey A, Sherbino J, Fan J, Mensour M, Upadhye S, Wasi P. A low-fidelity simulation curriculum addresses needs identified by faculty and improves the comfort level of senior internal medicine resident physicians with inhospital resuscitation. Crit Care Med 2010; 38 (09) 1899-1903
  • 10 Griesdale DE, Liu D, McKinney J, Choi PT. GlideScope® video-laryngoscopy versus direct laryngoscopy for endotracheal intubation: a systematic review and meta-analysis. Can J Anaesth 2012; 59 (01) 41-52
  • 11 Moussa A, Luangxay Y, Tremblay S. , et al. Videolaryngoscope for teaching neonatal endotracheal intubation: a randomized controlled trial. Pediatrics 2016; 137 (03) e20152156
  • 12 O'Shea JE, Thio M, Kamlin CO. , et al. Videolaryngoscopy to teach Nnonatal intubation: a randomized trial. Pediatrics 2015; 136 (05) 912-919
  • 13 Mittiga MR, Geis GL, Kerrey BT, Rinderknecht AS. The spectrum and frequency of critical procedures performed in a pediatric emergency department: implications of a provider-level view. Ann Emerg Med 2013; 61 (03) 263-270
  • 14 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 (10) 1056-1065
  • 15 Jungbauer A, Schumann M, Brunkhorst V, Börgers A, Groeben H. Expected difficult tracheal intubation: a prospective comparison of direct laryngoscopy and video laryngoscopy in 200 patients. Br J Anaesth 2009; 102 (04) 546-550
  • 16 Doane SM, Alderton DL, Sohn YW, Pellegrino JW. Acquisition and transfer of skilled performance: are visual discrimination skills stimulus specific?. J Exp Psychol Hum Percept Perform 1996; 22 (05) 1218-1248
  • 17 Vlatten A, Aucoin S, Litz S, Macmanus B, Soder C. A comparison of the STORZ video laryngoscope and standard direct laryngoscopy for intubation in the Pediatric airway--a randomized clinical trial. Paediatr Anaesth 2009; 19 (11) 1102-1107
  • 18 Fiadjoe JE, Kovatsis P. Videolaryngoscopes in pediatric anesthesia: what's new?. Minerva Anestesiol 2014; 80 (01) 76-82
  • 19 Howard-Quijano KJ, Huang YM, Matevosian R, Kaplan MB, Steadman RH. Video-assisted instruction improves the success rate for tracheal intubation by novices. Br J Anaesth 2008; 101 (04) 568-572