Endotracheal intubation by inexperienced trainees using the Clarus Video System: learning curve and orodental trauma perspectives
문영진, 김주영, 서동우, 김재원, 정혜원, 석은하, 하승일, 김성훈, 김정욱,
소속 상세정보
문영진 ( Moon Young-Jin ) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
김주영 ( Kim Ju-Young ) - Korea Health Promotion Foundation
서동우 ( Seo Dong-Woo ) - University of Ulsan College of Medicine Asan Medical Center Department of Emergency Medicine
김재원 ( Kim Jae-Won ) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
정혜원 ( Jung Hye-Won ) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
석은하 ( Suk Eun-Ha ) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
하승일 ( Ha Seung-Il ) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
김성훈 ( Kim Sung-Hoon ) - University of Ulsan College of Medicine Asan Medical Center Department of Obstetrics and Gynecology
김정욱 ( Kim Joung-Uk ) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
KMID : 0980320150150040207
Abstract
Background: The ideal alternative airway device should be intuitive to use, yielding proficiency after only a few trials. The Clarus Video System (CVS) is a novel optical stylet with a semi-rigid tip; however, the learning curve and associated orodental trauma are poorly understood.
Methods: Two novice practitioners with no CVS experience performed 30 intubations each. Each trial was divided into learning (first 10 intubations) and standard phases (remaining 20 intubations). Total time to achieve successful intubation, number of intubation attempts, ease of use, and orodental trauma were recorded.
Results: Intubation was successful in all patients. In 51 patients (85%), intubation was accomplished in the first attempt. Nine patients required two or three intubation attempts; six were with the first 10 patients. Learning and standard phases differed significantly in terms of success at first attempt, number of attempts, and intubation time (70% vs. 93%, 1.4 ± 0.7 vs. 1.1 ± 0.3, and 71.4 ± 92.3 s vs. 24.6 ± 21.9 s, respectively). The first five patients required longer intubation times than the subsequent five patients (106.8 ± 120.3 s vs. 36.0 ± 26.8 s); however, the number of attempts was similar. Sequential subgroups of five patients in the standard phase did not differ in the number of attempts or intubation time. Dental trauma, lip laceration, or mucosal bleeding were absent.
Conclusions: Ten intubations are sufficient to learn CVS utilization properly without causing any orodental trauma. A relatively small number of experiences are required in the learning curve compared with other devices.
키워드
Education; Intubation; Learning curve; Orodental trauma
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