Department of Anesthesiology and Pain Medicine, Hyogo College of Medicine.
Department of Anesthesiology, Fukuyama Medical Center.
Medicine (Baltimore). 2021 Jan 29;100(4):e23886. doi: 10.1097/MD.0000000000023886.
We compared the intubation skills obtained by novice doctors following training using 3 instruments, the conventional Macintosh laryngoscope (Mac) and 2 types of indirect video-laryngoscopes (McGrathTM-MAC: McGrath (McG) and AirwayScope (AWS)), to determine the most appropriate instrument for novice doctors to acquire intubation skills, especially focusing on visual confirmation of vocal cords, during a 3-day intensive manikin training program.
Fifteen novice doctors who did not have sufficient experience in endotracheal intubation (ETI) and consented to participate in this study were included. We used AirSim and AMT (Airway management Trainer) manikins. First, an experienced anesthesiologist instructed the trainees on using the 3 instruments for a few minutes. Then, after familiarizing themselves with each device for 10 minutes, the participants attempted ETI on the 2 manikins with the 3 devices used in random order. Intubations with each device were practiced and performed for 3 successive days. We assessed the percentage of glottic opening (POGO) score, successful intubation rate and tracheal intubation time for each participant, with each device, and on each day.
In the first manikin, AirSim, POGO scores in the McG and AWS groups were significantly higher than those in the Mac group on all 3 days (P < .0001). The number of intubation failures in the Mac group decreased from 2 cases on day 1, to 1 case on day 2 and zero cases on day 3. There were no failures in the McG and AWS groups on any of the days. With the second manikin, AMT, POGO scores in the Mac group were significantly lower than those in the McG and AWS groups on all 3 days. There were no intubation failures in the AWS group on all 3 days. In the Mac group, the number of intubation failures decreased from 3 on day 1, to 2 on day 2 and zero failures on day 3. In the McG group, there were only 3 failures on day 1.
The 2 types of indirect video-laryngoscopes (McGRATH and AirwayScope) were demonstrated to be suitable instruments for novice doctors to achieve higher POGO scores in a 3-day intensive ETI training.
我们比较了新手医生在使用 3 种器械（常规 Macintosh 喉镜（Mac）和 2 种间接视频喉镜（McGrathTM-MAC：McGrath（McG）和 AirwayScope（AWS））进行培训后获得的插管技能，以确定最适合新手医生在 3 天强化模型培训计划中获得插管技能的仪器，特别是在声带的视觉确认方面。
纳入了 15 名没有足够气管插管（ETI）经验且同意参与本研究的新手医生。我们使用了 AirSim 和 AMT（气道管理训练器）模型。首先，一位经验丰富的麻醉师指导受训者使用 3 种器械几分钟。然后，在熟悉每种设备 10 分钟后，参与者在 2 个模型上以随机顺序使用 3 种设备尝试 ETI。连续 3 天练习和执行每种设备的插管。我们评估了每位参与者使用每种设备在每一天的总声门显露（POGO）评分、成功插管率和气管插管时间。
在第一个模型，AirSim 中，McG 和 AWS 组在所有 3 天都显著高于 Mac 组（P<0.0001）。Mac 组的插管失败次数从第 1 天的 2 例减少到第 2 天的 1 例，第 3 天没有失败。在任何一天，McG 和 AWS 组都没有失败。在第二个模型，AMT 中，Mac 组的 POGO 评分在所有 3 天都显著低于 McG 和 AWS 组。在所有 3 天中，AWS 组都没有插管失败。在 Mac 组中，插管失败的次数从第 1 天的 3 例减少到第 2 天的 2 例，第 3 天没有失败。在 McG 组中，第 1 天只有 3 例失败。
2 种间接视频喉镜（McGRATH 和 AirwayScope）被证明是新手医生在 3 天强化 ETI 培训中获得更高 POGO 评分的合适仪器。
