Department of Respiratory Care Services, Duke University Medical Center, Durham, North Carolina.
Division of Anesthesiology, Duke University Medical Center, Durham, North Carolina.
Respir Care. 2020 Jul;65(7):954-960. doi: 10.4187/respcare.07338. Epub 2020 Mar 10.
Endotracheal intubation is a common procedure performed by respiratory therapists (RTs). The purpose of this study was to describe current RT intubation practices in North Carolina through the use of a survey instrument.
A survey was developed by the authors using REDCap. The survey was sent via email to all licensed RTs in North Carolina. Information collected included respondent demographics, intubation practices (including training and skill maintenance), and attitudes about RT intubation practices.
Of the 411 respondents, 68% intubated at their facility, representing 81 unique institutions. RTs who performed intubation were more likely to be from community hospitals and less likely to be from level 1 trauma centers. Respondents reported intubating adult (91%), pediatric (61%), and neonatal (65%) patients. The most common areas in which RTs reported performing intubation were the adult ICU (80%), emergency department (76%), outside the operating room for emergencies (76%), neonatal ICU (43%), the delivery room (45%), and pediatric ICU (25%). The median (interquartile range) number of supervised intubations required to be considered competent was 5 (3-5). The most common numbers of intubations required to be considered competent were 5 (32%), 3 (26%), 10 (16%), 2 (4%), and 0 (3%). The perceived number of intubations to achieve competence was 6 (range 5-10) and did not differ based on years of experience. Most respondents believed their RT intubation program was safe (93%) and effective (91%), and that RTs were well-trained (81%), that their intubation skills were objectively evaluated (66%), and that RTs receive sufficient feedback on performance (68%).
RTs in North Carolina frequently performed intubation and had high confidence in their programs. Further studies are needed to establish standardized training for endotracheal intubation, document success rates for intubations, and evaluate the use of video laryngoscopy by RTs.
气管插管是呼吸治疗师（RT）进行的常见程序。本研究的目的是通过使用调查工具描述北卡罗来纳州目前的 RT 插管实践。
作者使用 REDCap 开发了一项调查。该调查通过电子邮件发送给北卡罗来纳州的所有持照 RT。收集的信息包括受访者的人口统计学信息、插管实践（包括培训和技能维持）以及对 RT 插管实践的态度。
在 411 名受访者中，68%在其所在机构进行插管，代表 81 个独特的机构。进行插管的 RT 更有可能来自社区医院，而不太可能来自 1 级创伤中心。受访者报告说，他们插管的患者包括成人（91%）、儿科（61%）和新生儿（65%）。RT 报告说，他们最常进行插管的领域是成人 ICU（80%）、急诊部（76%）、手术室外紧急情况（76%）、新生儿 ICU（43%）、产房（45%）和儿科 ICU（25%）。认为有能力进行插管的受访者中位数（四分位距）需要接受 5（3-5）次监督插管。认为有能力进行插管的最常见次数为 5（32%）、3（26%）、10（16%）、2（4%）和 0（3%）。认为达到能力所需的插管次数为 6（5-10），与工作年限无关。大多数受访者认为他们的 RT 插管计划是安全有效的（93%和 91%），并且 RT 接受了良好的培训（81%）、他们的插管技能得到了客观评估（66%）并且他们的表现得到了足够的反馈（68%）。
北卡罗来纳州的 RT 经常进行插管，并且对他们的计划充满信心。需要进一步的研究来建立标准化的气管插管培训、记录插管成功率以及评估 RT 使用视频喉镜。
