The impact of introducing a videolaryngoscope in the initial training of laryngoscopy for undergraduate medical students: a simulation randomized trial

Introduction: Adequate and continuous airway management by health professionals is fundamental to ensure patient safety and protection. Among several techniques, laryngoscopy for orotracheal intubation is considered a basic skill, so it is taught and learned in medical school and used during the fut...

Full description

Bibliographic Details
Main Authors: Mauricio Luiz Malito, Ligia Andrade da Silva Telles Mathias, Aldemar Kimura Junior, Guilherme Haelvoet Correa, Vitor Ramalho Bardauil
Format: Article
Language:English
Published: Elsevier 2023-09-01
Series:Brazilian Journal of Anesthesiology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S0104001421001275
_version_ 1797679500038766592
author Mauricio Luiz Malito
Ligia Andrade da Silva Telles Mathias
Aldemar Kimura Junior
Guilherme Haelvoet Correa
Vitor Ramalho Bardauil
author_facet Mauricio Luiz Malito
Ligia Andrade da Silva Telles Mathias
Aldemar Kimura Junior
Guilherme Haelvoet Correa
Vitor Ramalho Bardauil
author_sort Mauricio Luiz Malito
collection DOAJ
description Introduction: Adequate and continuous airway management by health professionals is fundamental to ensure patient safety and protection. Among several techniques, laryngoscopy for orotracheal intubation is considered a basic skill, so it is taught and learned in medical school and used during the future years of professional practice. However, in some clinical scenarios, physical and anatomical characteristics can make laryngoscopy exceedingly difficult. In the last decade, some new devices have emerged to apply indirect or video-assisted imaging systems, so-called videolaryngoscopes. They have shown great efficiency in difficult intubation cases and have improved teaching and training. Our study introduced a videolaryngoscope, the McGrath... MAC, in the regular laryngoscopy training rotation for 3rd-year undergraduate medical students and evaluated whether there was any associated optimization of the students... performance. Method: Students from two different classes and years (2017 and 2018) were randomly divided into two groups and received theoretical and practical training in the techniques of Direct Laryngoscopy (DL) and Videolaryngoscopy (VL). The students in each group applied the manoeuvres and simulated three tracheal intubation attempts on mannequins. They were evaluated for their success rate on the first attempt, the time required to finalize the intubation, and the visualization of the glottic structures according to the classification of Cormack-Lehane (C&L). Results: Two hundred and four students with an average age of 21.ß...ß2 years participated in the study; the groups were similar. There was a significant difference between the VL and DL groups in the 1st attempt success rate (97% and 89.4%, respectively, p.ß=.ß0.0497 ... 95% CI), but such a difference was not seen for the other attempts or regarding the number of oesophageal intubations (3% and 7.7%). The students in the VL group were faster than those in the DL group in all intubation attempts; in parallel, the vast majority of the VL group reported excellent visualization conditions, with 75% of the attempts classified as Cormack-Lehane grade 1. Conclusion: The introduction of a videolaryngoscope in medical students... training improved the visualization of anatomical structures and allowed tracheal intubation maneuvers to be performed faster and with a higher success rate on the first attempt. Thus, under the conditions of this prospective study, the videolaryngoscope had a positive impact on training and proved to be a promising tool for teaching laryngoscopy.
first_indexed 2024-03-11T23:15:34Z
format Article
id doaj.art-7130d396b8f34ba68ce1cd7143ffbeff
institution Directory Open Access Journal
issn 0104-0014
language English
last_indexed 2024-03-11T23:15:34Z
publishDate 2023-09-01
publisher Elsevier
record_format Article
series Brazilian Journal of Anesthesiology
spelling doaj.art-7130d396b8f34ba68ce1cd7143ffbeff2023-09-21T04:36:01ZengElsevierBrazilian Journal of Anesthesiology0104-00142023-09-01735532538The impact of introducing a videolaryngoscope in the initial training of laryngoscopy for undergraduate medical students: a simulation randomized trialMauricio Luiz Malito0Ligia Andrade da Silva Telles Mathias1Aldemar Kimura Junior2Guilherme Haelvoet Correa3Vitor Ramalho Bardauil4CET/SBA da Santa Casa de S.·o Paulo, S.·o Paulo, SP, Brazil; Hospital AACD, CTVA (Centro de Treinamento em Vias A..reas), S.·o Paulo, SP, Brazil; Corresponding author.Santa Casa de S.·o Paulo, Faculdade de Ci.¼ncias M..dicas, S.·o Paulo, SP, Brazil; Promatre Paulista, Servi..o de Anestesia, S.·o Paulo, SP, BrazilCET/SBA da Santa Casa de S.·o Paulo, S.·o Paulo, SP, Brazil; Hospital Sabar.., S.·o Paulo, SP, Brazil; Hospital AACD, S.·o Paulo, SP, BrazilHospital Santa Joana, S.·o Paulo, SP, BrazilCET/SBA da Santa Casa de S.·o Paulo, S.·o Paulo, SP, BrazilIntroduction: Adequate and continuous airway management by health professionals is fundamental to ensure patient safety and protection. Among several techniques, laryngoscopy for orotracheal intubation is considered a basic skill, so it is taught and learned in medical school and used during the future years of professional practice. However, in some clinical scenarios, physical and anatomical characteristics can make laryngoscopy exceedingly difficult. In the last decade, some new devices have emerged to apply indirect or video-assisted imaging systems, so-called videolaryngoscopes. They have shown great efficiency in difficult intubation cases and have improved teaching and training. Our study introduced a videolaryngoscope, the McGrath... MAC, in the regular laryngoscopy training rotation for 3rd-year undergraduate medical students and evaluated whether there was any associated optimization of the students... performance. Method: Students from two different classes and years (2017 and 2018) were randomly divided into two groups and received theoretical and practical training in the techniques of Direct Laryngoscopy (DL) and Videolaryngoscopy (VL). The students in each group applied the manoeuvres and simulated three tracheal intubation attempts on mannequins. They were evaluated for their success rate on the first attempt, the time required to finalize the intubation, and the visualization of the glottic structures according to the classification of Cormack-Lehane (C&L). Results: Two hundred and four students with an average age of 21.ß...ß2 years participated in the study; the groups were similar. There was a significant difference between the VL and DL groups in the 1st attempt success rate (97% and 89.4%, respectively, p.ß=.ß0.0497 ... 95% CI), but such a difference was not seen for the other attempts or regarding the number of oesophageal intubations (3% and 7.7%). The students in the VL group were faster than those in the DL group in all intubation attempts; in parallel, the vast majority of the VL group reported excellent visualization conditions, with 75% of the attempts classified as Cormack-Lehane grade 1. Conclusion: The introduction of a videolaryngoscope in medical students... training improved the visualization of anatomical structures and allowed tracheal intubation maneuvers to be performed faster and with a higher success rate on the first attempt. Thus, under the conditions of this prospective study, the videolaryngoscope had a positive impact on training and proved to be a promising tool for teaching laryngoscopy.http://www.sciencedirect.com/science/article/pii/S0104001421001275Airway managementIntubationIntratrachealMedical studentsMannequinsLaryngoscopy
spellingShingle Mauricio Luiz Malito
Ligia Andrade da Silva Telles Mathias
Aldemar Kimura Junior
Guilherme Haelvoet Correa
Vitor Ramalho Bardauil
The impact of introducing a videolaryngoscope in the initial training of laryngoscopy for undergraduate medical students: a simulation randomized trial
Brazilian Journal of Anesthesiology
Airway management
Intubation
Intratracheal
Medical students
Mannequins
Laryngoscopy
title The impact of introducing a videolaryngoscope in the initial training of laryngoscopy for undergraduate medical students: a simulation randomized trial
title_full The impact of introducing a videolaryngoscope in the initial training of laryngoscopy for undergraduate medical students: a simulation randomized trial
title_fullStr The impact of introducing a videolaryngoscope in the initial training of laryngoscopy for undergraduate medical students: a simulation randomized trial
title_full_unstemmed The impact of introducing a videolaryngoscope in the initial training of laryngoscopy for undergraduate medical students: a simulation randomized trial
title_short The impact of introducing a videolaryngoscope in the initial training of laryngoscopy for undergraduate medical students: a simulation randomized trial
title_sort impact of introducing a videolaryngoscope in the initial training of laryngoscopy for undergraduate medical students a simulation randomized trial
topic Airway management
Intubation
Intratracheal
Medical students
Mannequins
Laryngoscopy
url http://www.sciencedirect.com/science/article/pii/S0104001421001275
work_keys_str_mv AT mauricioluizmalito theimpactofintroducingavideolaryngoscopeintheinitialtrainingoflaryngoscopyforundergraduatemedicalstudentsasimulationrandomizedtrial
AT ligiaandradedasilvatellesmathias theimpactofintroducingavideolaryngoscopeintheinitialtrainingoflaryngoscopyforundergraduatemedicalstudentsasimulationrandomizedtrial
AT aldemarkimurajunior theimpactofintroducingavideolaryngoscopeintheinitialtrainingoflaryngoscopyforundergraduatemedicalstudentsasimulationrandomizedtrial
AT guilhermehaelvoetcorrea theimpactofintroducingavideolaryngoscopeintheinitialtrainingoflaryngoscopyforundergraduatemedicalstudentsasimulationrandomizedtrial
AT vitorramalhobardauil theimpactofintroducingavideolaryngoscopeintheinitialtrainingoflaryngoscopyforundergraduatemedicalstudentsasimulationrandomizedtrial
AT mauricioluizmalito impactofintroducingavideolaryngoscopeintheinitialtrainingoflaryngoscopyforundergraduatemedicalstudentsasimulationrandomizedtrial
AT ligiaandradedasilvatellesmathias impactofintroducingavideolaryngoscopeintheinitialtrainingoflaryngoscopyforundergraduatemedicalstudentsasimulationrandomizedtrial
AT aldemarkimurajunior impactofintroducingavideolaryngoscopeintheinitialtrainingoflaryngoscopyforundergraduatemedicalstudentsasimulationrandomizedtrial
AT guilhermehaelvoetcorrea impactofintroducingavideolaryngoscopeintheinitialtrainingoflaryngoscopyforundergraduatemedicalstudentsasimulationrandomizedtrial
AT vitorramalhobardauil impactofintroducingavideolaryngoscopeintheinitialtrainingoflaryngoscopyforundergraduatemedicalstudentsasimulationrandomizedtrial