Page 35 - Delaware Medical Journal - March/April 2019
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OBSERVATIONAL STUDY
VL
72% (72/100)
C-MAC-DL 23% (23/100)
DL
5% (5/100)
VL
88% (31/35)
C-MAC-DL 8.5% (3/35)
DL 2.8% (1/35)
questionnaire was also administered to the intubating physician by the research students.
Primary endpoints recorded included post-graduate year (PGY) of the intubating physician, the initial intubation
The intubating options utilized at our center included direct laryngoscopy utilizing a Mac or Miller blade or video laryngoscopy utilizing a C-MAC (Karl Storz Endoscopy, El Segundo, CA) device. When operators utilized VL, they had the option to use the device as DL, in which the operator did not use the video screen to assist in endotracheal intubation, recorded as C-MAC DL. Alternatively, operators performing VL who used the video screen were recorded as C-MAC
VL. Secondary endpoints included the reason for intubation, total number of intubation attempts needed for successful endotracheal intubation, adverse events, and the need for
a rescue method such as an alternate device or change in laryngoscope/endotracheal tube into the mouth with successful
FIGURE 1
Intubation Attempts (n=135)
First Pass Success 74.1% (n=100)
Failed Attempt 25.9% (n=35)
or scenarios where VL is not available. This could include smaller and rural EDs, equipment malfunction, or scenarios blood/liquid within the airway that could obscure the camera. This information can then be used to guide future curriculum changes to ensure EM residents are adequately educated in all methods of airway management.
METHODS
This study utilized a cross-sectional, prospective observational design within a large academic ED at a Level 1 Trauma Center supporting an EM residency program, as well as combined Emergency Medicine-Internal Medicine and Emergency Medicine-Family Medicine residencies. All patients aged 18 years and older requiring intubation from September 2016 through April 2017 were included in the study. Data was collected in real time by research students via direct observation after undergoing an educational seminar on airway management. A short post-intubation
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