Johnston Lindsay C, Auerbach Marc, Kappus Liana, Emerson Beth, Zigmont Jason, Sudikoff Stephanie N
a Neonatal-Perinatal Medicine, Yale University School of Medicine , New Haven , Connecticut , USA.
Teach Learn Med. 2014;26(3):285-91. doi: 10.1080/10401334.2014.910462.
GlideScope (GS) is used in pediatric endotracheal intubation (ETI) but requires a different technique compared to direct laryngoscopy (DL).
This article was written to evaluate the efficacy of exploration-based learning on procedural performance using GS for ETI of simulated pediatric airways and establish baseline success rates and procedural duration using DL in airway trainers among pediatric providers at various levels.
Fifty-five pediatric residents, fellows, and faculty from Pediatric Critical Care, NICU, and Pediatric Emergency Medicine were enrolled. Nine physicians from Pediatric Anesthesia benchmarked expert performance. Participants completed a demographic survey and viewed a video by the GS manufacturer. Subjects spent 15 minutes exploring GS equipment and practicing the intubation procedure. Participants then intubated neonatal, infant, child, and adult airway simulators, using GS and DL, in random order. Time to ETI was recorded.
Procedural performance after exploration-based learning, measured as time to successful ETI, was shorter for DL than for GS for neonatal and child airways at the.05 significance level. Time to ETI in adult airway using DL was correlated with experience level (p =.01). Failure rates were not different among subgroups.
A brief video and period of exploration-based learning is insufficient for implementing a new technology. Pediatricians at various levels of training intubated simulated airways faster using DL than GS.
GlideScope（GS）用于小儿气管插管（ETI），但与直接喉镜检查（DL）相比需要不同的技术。
撰写本文是为了评估基于探索性学习对使用GS进行模拟小儿气道ETI的操作性能的效果，并确定不同级别儿科医疗人员在气道训练器中使用DL的基线成功率和操作持续时间。
招募了来自儿科重症监护、新生儿重症监护病房和儿科急诊医学的55名儿科住院医师、研究员和教员。来自儿科麻醉科的9名医生作为专家操作的基准。参与者完成了一项人口统计学调查，并观看了GS制造商提供的视频。受试者花15分钟探索GS设备并练习插管程序。然后，参与者使用GS和DL以随机顺序对新生儿、婴儿、儿童和成人气道模拟器进行插管。记录达到ETI的时间。
在.05显著性水平上，对于新生儿和儿童气道，基于探索性学习后的操作性能（以成功ETI的时间衡量），DL比GS短。在成人气道中使用DL达到ETI的时间与经验水平相关（p =.01）。各亚组的失败率没有差异。
一段简短的视频和基于探索性学习的时间段不足以实施一项新技术。各级培训水平的儿科医生使用DL对模拟气道进行插管比使用GS更快。
