Beyond tools: continuous high-fidelity training at the center of successful first-pass intubation in ground emergency medical services
Shaw, Matthew R., Lindsay, Daniel, and Figueroa, Alejandra (2020) Beyond tools: continuous high-fidelity training at the center of successful first-pass intubation in ground emergency medical services. Air Medical Journal, 39 (5). pp. 364-368.
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Abstract
Objective: Increased emphasis on the use of video laryngoscopy in emergency medical services has potentially caused providers to forfeit the skills required to perform direct laryngoscopy. The purpose of this study was to determine if the introduction of a continuous high-fidelity training program improves first-pass intubation success in a non–rapid sequence induction ground-based emergency medical services agency with an established video laryngoscopy program.
Methods: This is a retrospective analysis of quality improvement data of advanced airway management performed by an ambulance service between 2012 and 2019. A mandatory biannual high-fidelity simulation training curriculum was introduced at the beginning of 2017.
Results: A total of 459 patients underwent intubation attempts during the 7-year study period. First-pass intubation success improved from 57.6% to 81.4%, an improvement of 23.8% (95% confidence interval [CI], 15.4-31.5; P < .001), and overall intubation success improved from 77% to 91%, an improvement of 14.1% (95% CI, 7.3-20.3; P < .001). The average number of intubation attempts per patient decreased by 0.19 (95% CI, 0.09-0.29; P < .0003). The mean time of arrival to intubation time increased by 2.21 minutes (95% CI, 0.84-3.58; P = .0016).
Conclusion: Implementation of a high-fidelity airway training program is associated with improvements in overall endotracheal intubation and first-pass endotracheal intubation success rates in all adult patient categories.
| Item ID: | 65274 |
|---|---|
| Item Type: | Article (Research - C1) |
| ISSN: | 1532-6497 |
| Copyright Information: | © 2020 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved. |
| Date Deposited: | 08 Dec 2020 23:39 |
| FoR Codes: | 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320219 Paramedicine @ 100% |
| SEO Codes: | 92 HEALTH > 9299 Other Health > 929999 Health not elsewhere classified @ 100% |
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