Hall Robert E, Plant Jeff R, Bands Colin J, Wall Alastair R, Kang Jian, Hall Christine A
Department of Emergency Medicine, University of Calgary, Calgary, Alberta, Canada.
Acad Emerg Med. 2005 Sep;12(9):850-5. doi: 10.1197/j.aem.2005.04.007.
The primary purpose of this study was to determine whether the endotracheal intubation (ETI) success rate is different among paramedic students trained on a human patient simulator versus on human subjects in the operating room (OR).
Paramedic students (n = 36) with no prior ETI training received identical didactic and mannequin teaching. After randomization, students were trained for ten hours on a patient simulator (SIM) or with 15 intubations on human subjects in the OR. All students then underwent a formalized test of 15 intubations in the OR. The primary outcome was the rate of successful intubation. Secondary outcomes were the success rate at first attempt and the complication rate. The study was powered to detect a 10% difference for the overall success rate (alpha = 0.05, beta = 0.20).
The overall intubation success rate was 87.8% in the SIM group and 84.8% in the OR group (difference of 3.0% [95% confidence interval {CI} = -4.2% to 10.1%; p = 0.42]). The success rate on the first attempt was 84.4% in the SIM group and 80.0% in the OR group (difference of 4.4% [95% CI = -3.4% to 12.3%; p = 0.27]). The complication rate was 6.3% in the SIM group and 4.4% in the OR group (difference of 1.9% [95% CI = -2.9% to 6.6%; p = 0.44]).
When tested in the OR, paramedic students who were trained in ETI on a simulator are as effective as students who trained on human subjects. The results support using simulators to teach ETI.
本研究的主要目的是确定接受人类患者模拟器培训的护理专业学生与在手术室（OR）接受人体受试者培训的护理专业学生相比，气管插管（ETI）成功率是否存在差异。
36名此前未接受过ETI培训的护理专业学生接受了相同的理论和模拟人教学。随机分组后，学生们在患者模拟器（SIM）上接受了10小时的培训，或在手术室对人体受试者进行了15次插管操作。然后，所有学生在手术室接受了15次插管的正式测试。主要结局是插管成功率。次要结局是首次尝试成功率和并发症发生率。该研究的效能足以检测出总体成功率10%的差异（α = 0.05，β = 0.20）。
SIM组的总体插管成功率为87.8%，OR组为84.8%（差异为3.0% [95%置信区间{CI} = -4.2%至10.1%；p = 0.42]）。SIM组首次尝试成功率为84.4%，OR组为80.0%（差异为4.4% [95% CI = -3.4%至12.3%；p = 0.27]）。SIM组的并发症发生率为6.3%，OR组为4.4%（差异为1.9% [95% CI = -2.9%至6.6%；p = 0.44]）。
在手术室进行测试时，在模拟器上接受ETI培训的护理专业学生与在人体受试者上接受培训的学生效果相同。结果支持使用模拟器教授ETI。
