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Manikin to patient intubation: does it translate?

Journal of Perinatology volume 43, pages 233–235 (2023)Cite this article

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Endotracheal intubation is a vital component for resuscitating critically ill neonates, and pediatric resident physicians are required to competently perform endotracheal intubations before graduation [1]. However, many trainees do not successfully demonstrate procedural competence, and there continue to be fewer opportunities for them to perform endotracheal intubations. One study reported that pediatric residents attempted only 15% of intubations performed in the NICU and only 2% of intubations performed in the delivery room [2]. Another study reported a median of 3 intubation opportunities per pediatric resident during their residency training [3]. Notably, data from the anesthesia literature suggest that at least 47 intubation attempts may be required to achieve procedural competence, which was defined as a 90% success rate [4].

Given the limited opportunities for residents to perform endotracheal intubations on live neonates, simulation training is a promising teaching method to ensure residents attain competence in this life-saving skill. We sought to determine if simulation training with the instructor using a videolaryngoscope to guide residents who were using direct laryngoscopy would improve the intubation success rate of pediatric residents if attended at the beginning of the NICU rotation. While videolaryngoscopy has shown improved intubation success rates and reduced adverse intubation associated events [5, 6], the residents in this study used direct laryngoscopy because that is what is generally available in the community where they will practice.

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Data availability

A limited data set that supports the findings of this study are available at clinicaltrials.gov (NCT03046966). Further enquiries can be directed to the corresponding author.

References

  1. 2020 Accreditation Council for Graduate Medical Education (ACGME). ACGME program requirements for graduate medical education in pediatrics. 2020. https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/320_Pediatrics_2020.pdf?ver=2020-06-29-162726-647. Accessed 7 February 2021.

  2. Foglia EE, Ades A, Sawyer T, Glass KM, Singh N, Jung P, et al. Neonatal intubation practice and outcomes: an international registry study. Pediatrics. 2019;143:https://doi.org/10.1542/peds.2018-0902.

  3. DeMeo SD, Katakam L, Goldberg RN, Tanaka D. Predicting neonatal intubation competency in trainees. Pediatrics. 2015;135:e1229–36.

    Article  Google Scholar 

  4. Mulcaster JT, Mills J, Hung OR, MacQuarrie K, Law JA, Pytka S, et al. Laryngoscopic intubation: learning and performance. Anesthesiology. 2003;98:23–27.

    Article  Google Scholar 

  5. Moussa A, Luangxay Y, Tremblay S, Lavoie J, Aube G, Savoie E, et al. Videolaryngoscope for teaching neonatal endotracheal intubation: a randomized controlled trial. Pediatrics. 2016;137:e20152156–2156.

    Article  Google Scholar 

  6. Moussa A, Sawyer T, Puia-Dumitrescu M, Foglia EE, Ades A, Napolitano N, et al. Does videolaryngoscopy improve tracheal intubation first attempt success in the NICUs? A report from the NEAR4NEOS. J Perinatol. 2022;42:1210–5.

    Article  Google Scholar 

  7. American Academy of Pediatrics. American Heart Association: textbook of neonatal resuscitation (NRP), 7th ed. Elk Grove, IL: American Academy of Pediatrics; 2016.

  8. Falck AJ, Escobedo MB, Baillargeon JG, Villard LG, Gunkel JH. Proficiency of pediatric residents in performing neonatal endotracheal intubation. Pediatrics. 2003;112:1242–7.

    Article  Google Scholar 

  9. Evans P, Shults J, Weinberg DD, Napolitano N, Ades A, Johnston L, et al. Intubation competence during neonatal fellowship training. Pediatrics. 2021;148:https://doi.org/10.1542/peds.2020-036145.

  10. Andreatta PB, Dooley-Hash SL, Klotz JJ, Hauptman JG, Biddinger B, House JB. Retention curves for pediatric and neonatal intubation skills after simulation-based training. Pediatr Emerg Care. 2016;32:71–76.

    Article  Google Scholar 

  11. Johnston L, Sawyer T, Nishisaki A, Whitfill T, Ades A, French H, et al. Neonatal intubation competency assessment tool: development and validation. Acad Pediatr. 2019;19:157–64.

    Article  Google Scholar 

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Funding

Funding for the study was provided by NIH/NIGMS (P30GM110702). The funding source did not contribute to the study design or execution, data analysis, or manuscript preparation.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Neonatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Jennifer Rumpel, John Stack & Richard W. Hall

  2. Department of Pediatrics, Division of Neonatology, West Virginia University, Morgantown, WV, USA

    Lakeya O’Neal

  3. Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Nicholas Kaukis

  4. College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Sydney Rogers

  5. Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Janice Hollenberg

Authors
  1. Jennifer Rumpel
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  2. Lakeya O’Neal
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  4. Sydney Rogers
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  5. John Stack
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  6. Janice Hollenberg
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  7. Richard W. Hall
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Contributions

JR, MD, substantially contributed through investigation, data curation, formal analysis, and writing and revising the manuscript. LO, MD, substantially contributed through investigation, data curation, and writing the manuscript. NK, PhD, substantially contributed through formal statistical analysis and editing the manuscript. SR substantially contributed through investigation, data curation, formal analysis, and writing the manuscript. JH substantially contributed through investigation, data curation, and writing the manuscript. RWH, MD substantially contributed through conceptualization, methodology, investigation, supervision, funding acquisition, data curation, and writing and revising the manuscript.

Corresponding author

Correspondence to Jennifer Rumpel.

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Competing interests

The authors declare no competing interests.

Ethics approval

Participating residents gave their written informed consent prior to participating in the study. The study protocol was approved by the UAMS Institutional Review Board (IRB 205053).

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Rumpel, J., O’Neal, L., Kaukis, N. et al. Manikin to patient intubation: does it translate?. J Perinatol 43, 233–235 (2023). https://doi.org/10.1038/s41372-022-01553-9

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