Swaminathan Anand Kumar, Berkowitz Rachel, Baker Annalee, Spyres Meghan
Department of Emergency Medicine, New York University School of Medicine/Bellevue Hospital, New York, New York.
J Emerg Med. 2015 May;48(5):613-9. doi: 10.1016/j.jemermed.2014.12.029. Epub 2015 Jan 31.
Video laryngoscopy (VL) has emerged as a critical tool in the "difficult airway" armamentarium of emergency physicians. The resultant increase in the types of available VL devices has made Emergency Medicine Residency (EMR) training in VL increasingly challenging. Additionally, the prevalence of VL devices in the community is unknown. Because Emergency Medicine (EM) residents go on to work in diverse settings, many in non-EMR emergency departments (EDs), it is preferable that they receive training on the airway modalities they will encounter in practice.
To compare the prevalence and type of VL devices in EMR programs to non-EMR EDs.
This was a survey study conducted from July 2012 to October 2012 of Accreditation Council for Graduate Medical Education-accredited, MD EMR programs in the United States and non-EMR EDs in New York State. A chi-squared test was performed to determine whether the difference in VL prevalence was significant.
There were 158 EMR programs and 132 non-EMR EDs surveyed; 97.8% of EMR and 84.3% of non-EMR EDs reported having some form of VL in their departments. The difference in proportion of EMR vs. non-EMR EDs that have VL was χ(2) = 13 (p < 0.001). The Glidescope® device (Verathon Medical, Bothell, WA) was present in 87.7% of EMR programs and 79.3% of non-EMR EDs.
The majority of EMR programs trained residents in VL. The Glidescope device was used most frequently. Non-EMR EDs in New York State had a lower presence of VL devices, with the Glidescope device again being the most common. These results demonstrate that VL is pervasive in both practice environments.
视频喉镜(VL)已成为急诊医生“困难气道”装备中的关键工具。可用VL设备类型的增加使得急诊医学住院医师培训(EMR)中关于VL的培训越来越具有挑战性。此外,社区中VL设备的普及率尚不清楚。由于急诊医学(EM)住院医师毕业后会在不同环境中工作,许多人会在非EMR急诊科(ED)工作,因此最好让他们接受在实际工作中会遇到的气道诊疗方式的培训。
比较EMR项目与非EMR急诊科中VL设备的普及率和类型。
这是一项于2012年7月至2012年10月进行的调查研究,研究对象为美国研究生医学教育认证委员会认证的MD EMR项目以及纽约州的非EMR急诊科。采用卡方检验来确定VL普及率的差异是否显著。
共调查了158个EMR项目和132个非EMR急诊科;97.8%的EMR项目和84.3%的非EMR急诊科报告其科室拥有某种形式的VL。拥有VL的EMR急诊科与非EMR急诊科的比例差异为χ(2)=13(p<0.001)。Glidescope®设备(Verathon Medical,华盛顿州博塞尔)在87.7%的EMR项目和79.3%的非EMR急诊科中存在。
大多数EMR项目对住院医师进行了VL培训。Glidescope设备使用最为频繁。纽约州的非EMR急诊科中VL设备的普及率较低,Glidescope设备仍是最常见的。这些结果表明VL在这两种实践环境中都很普遍。