Defining and developing expertise in tracheal intubation using a GlideScope® for anaesthetists with expertise in Macintosh direct laryngoscopy: An in-vivo longitudinal study

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

Although videolaryngoscopy can provide excellent views of the laryngeal structures as both the primary method of tracheal intubation and as a rescue technique for difficult direct laryngoscopy, the existing literature is inadequate to define expertise or even competence. We observed the performance of nine trainees during 890 intubations, with an additional 72 intubations performed by expert anaesthetists used as a control group. Univariate and multivariate mixed-effects logistic regression models were applied to detect potential predictors of successful intubation and define the number of intubations necessary for a trainee to achieve expertise (> 90% probability of optimal performance). Optimal performance was predicted by single laryngoscope insertion (p <0.001) and a Cormack and Lehane grade-1 view (p <0.001), and not by normal lifting force applied to the device (p = 0.15), with expertise reached after 76 attempts. These results indicate that expertise in videolaryngoscopy requires prolonged training and practice.

Original languageEnglish
Pages (from-to)290-295
Number of pages6
JournalAnaesthesia
Volume70
Issue number3
DOIs
Publication statusPublished - Mar 1 2015

Fingerprint

Laryngoscopy
Intubation
Longitudinal Studies
Logistic Models
Laryngoscopes
Mental Competency
Anesthetists
Equipment and Supplies
Control Groups

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Medicine(all)

Cite this

@article{dc05c03f4f0a4f4a96fb9d805c47acf8,
title = "Defining and developing expertise in tracheal intubation using a GlideScope{\circledR} for anaesthetists with expertise in Macintosh direct laryngoscopy: An in-vivo longitudinal study",
abstract = "Although videolaryngoscopy can provide excellent views of the laryngeal structures as both the primary method of tracheal intubation and as a rescue technique for difficult direct laryngoscopy, the existing literature is inadequate to define expertise or even competence. We observed the performance of nine trainees during 890 intubations, with an additional 72 intubations performed by expert anaesthetists used as a control group. Univariate and multivariate mixed-effects logistic regression models were applied to detect potential predictors of successful intubation and define the number of intubations necessary for a trainee to achieve expertise (> 90{\%} probability of optimal performance). Optimal performance was predicted by single laryngoscope insertion (p <0.001) and a Cormack and Lehane grade-1 view (p <0.001), and not by normal lifting force applied to the device (p = 0.15), with expertise reached after 76 attempts. These results indicate that expertise in videolaryngoscopy requires prolonged training and practice.",
author = "P. Cortellazzi and D. Caldiroli and A. Byrne and A. Sommariva and Orena, {E. F.} and I. Tramacere",
year = "2015",
month = "3",
day = "1",
doi = "10.1111/anae.12878",
language = "English",
volume = "70",
pages = "290--295",
journal = "Anaesthesia",
issn = "0003-2409",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Defining and developing expertise in tracheal intubation using a GlideScope® for anaesthetists with expertise in Macintosh direct laryngoscopy

T2 - An in-vivo longitudinal study

AU - Cortellazzi, P.

AU - Caldiroli, D.

AU - Byrne, A.

AU - Sommariva, A.

AU - Orena, E. F.

AU - Tramacere, I.

PY - 2015/3/1

Y1 - 2015/3/1

N2 - Although videolaryngoscopy can provide excellent views of the laryngeal structures as both the primary method of tracheal intubation and as a rescue technique for difficult direct laryngoscopy, the existing literature is inadequate to define expertise or even competence. We observed the performance of nine trainees during 890 intubations, with an additional 72 intubations performed by expert anaesthetists used as a control group. Univariate and multivariate mixed-effects logistic regression models were applied to detect potential predictors of successful intubation and define the number of intubations necessary for a trainee to achieve expertise (> 90% probability of optimal performance). Optimal performance was predicted by single laryngoscope insertion (p <0.001) and a Cormack and Lehane grade-1 view (p <0.001), and not by normal lifting force applied to the device (p = 0.15), with expertise reached after 76 attempts. These results indicate that expertise in videolaryngoscopy requires prolonged training and practice.

AB - Although videolaryngoscopy can provide excellent views of the laryngeal structures as both the primary method of tracheal intubation and as a rescue technique for difficult direct laryngoscopy, the existing literature is inadequate to define expertise or even competence. We observed the performance of nine trainees during 890 intubations, with an additional 72 intubations performed by expert anaesthetists used as a control group. Univariate and multivariate mixed-effects logistic regression models were applied to detect potential predictors of successful intubation and define the number of intubations necessary for a trainee to achieve expertise (> 90% probability of optimal performance). Optimal performance was predicted by single laryngoscope insertion (p <0.001) and a Cormack and Lehane grade-1 view (p <0.001), and not by normal lifting force applied to the device (p = 0.15), with expertise reached after 76 attempts. These results indicate that expertise in videolaryngoscopy requires prolonged training and practice.

UR - http://www.scopus.com/inward/record.url?scp=84922593441&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84922593441&partnerID=8YFLogxK

U2 - 10.1111/anae.12878

DO - 10.1111/anae.12878

M3 - Article

C2 - 25271442

AN - SCOPUS:84922593441

VL - 70

SP - 290

EP - 295

JO - Anaesthesia

JF - Anaesthesia

SN - 0003-2409

IS - 3

ER -