Endotracheal intubation is a life saving procedure where a tube is placed into a person's windpipe to help them to breathe. This is a study of which shape of tube would lead to improved success in this procedure.
Endotracheal intubation (ETI) is a lifesaving procedure. It involves placing a tube in the patient's airway to maintain ventilation and oxygenation. Simulation has been shown to be effective for medical procedural skills training. Medical simulation literature now focuses on instructional design (ID) features that improve learning. There are multiple aspects of ETI technique and ID that can be modified to improve successful ETI. Patient positioning, mastery learning, and dyad rather than solo practice are examples for which evidence exists to guide instructors. Despite this, ETI complication rates are substantial. Thus, areas for continued improvement in ETI ID should be explored. One area is the optimal endotracheal tube (ETT) shape, achieved using a stylet, for novices learning ETI, for which there is limited evidence. The straight to cuff (STC) shape has been postulated to optimise views of the airway compared to an arcuate shape. These shapes have only been directly compared as subgroups among multiple other comparisons in ETI technique in difficult intubations in one study. This does not generalise well to educating novices such as medical students, where intubations at normal difficulty are within the learner's zone of proximal development, and findings from subgroup comparisons are hypothesis generating rather than definitive evidence This study will compare which shape is most likely to lead to successful endotracheal intubation, when performed by novices (medical students) learning this procedure on mannequins.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
268
Placement of an endotracheal tube into a simulated trachea in a mannequin using the abovementioned shape
Placement of an endotracheal tube into a simulated trachea in a mannequin using the abovementioned shape
Yong Loo Lin School of Medicine, National University of Singapore
Singapore, Singapore
RECRUITINGTime to successful intubation
Defined as the time between insertion of the laryngoscope to successful placement of the tube in the trachea
Time frame: Outcome assessment will occur within 2 weeks of endotracheal intubation being taught to participants, and immediately upon randomisation to a specified shape to attempt endotracheal intubation under video recording
Proportion of participants who successfully intubate on first pass of laryngoscope
Defined as successful placement of the tube into the trachea with only one insertion of the laryngoscope blade into the mouth
Time frame: Outcome assessment will occur within 2 weeks of endotracheal intubation being taught to participants, and immediately upon randomisation to a specified shape to attempt endotracheal intubation under video recording
Proportion of participants who successfully intubate on first pass of endotracheal tube
Defined as successful placement of the tube into the trachea with only one insertion of the endotracheal tube into the mouth
Time frame: Outcome assessment will occur within 2 weeks of endotracheal intubation being taught to participants, and immediately upon randomisation to a specified shape to attempt endotracheal intubation under video recording
Proportion of participants who perform an oesophageal intubation
Defined as placement of the endotracheal tube into the oesophagus as the end state of the participant's attempt
Time frame: Outcome assessment will occur within 2 weeks of endotracheal intubation being taught to participants, and immediately after their intubation attempt under video recording
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