Michael J Silverberg1, Pierre Kory. 1. Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Medical Center, New York, New York.
Abstract
RATIONALE: Recent studies on video laryngoscopy have demonstrated improvements in both safety and success of endotracheal intubation in the critically ill. OBJECTIVES: We assessed the use of video laryngoscopy among internal medicine fellowship programs training physicians in critical care medicine. METHODS: A 19-question survey was e-mailed to program directors of pulmonary/critical care and internal medicine critical care fellowship training programs. MEASUREMENTS AND MAIN RESULTS: A completed survey was returned by 36% of invited program directors. Sixty-nine percent of respondents reported a change in their approach to intubation training over the prior 3 years, with 56% of changes attributed to the adoption of a video laryngoscope. Other reported changes include new training methods (23%) and adoption of a checklist (10%). A video laryngoscope is available for clinical use in 89% of the responding programs. The video scope is used as the primary device in 16% and is never used in 9%. In the remainder of programs, the video laryngoscope is only used for difficult intubations or after failure of direct laryngoscopy (32%) or the primary device is determined by the preference of the operator (32%). CONCLUSIONS: The majority of internal medicine critical care program directors who recently responded to an e-mail survey reported that they have changed their approach to teaching endotracheal intubation, driven largely by the adoption of video laryngoscopy for upper airway visualization. Nevertheless, despite widespread availability, video laryngoscopy is used uncommonly as the primary visualization device for intubation at the programs represented by the respondents to this survey.
RATIONALE: Recent studies on video laryngoscopy have demonstrated improvements in both safety and success of endotracheal intubation in the critically ill. OBJECTIVES: We assessed the use of video laryngoscopy among internal medicine fellowship programs training physicians in critical care medicine. METHODS: A 19-question survey was e-mailed to program directors of pulmonary/critical care and internal medicine critical care fellowship training programs. MEASUREMENTS AND MAIN RESULTS: A completed survey was returned by 36% of invited program directors. Sixty-nine percent of respondents reported a change in their approach to intubation training over the prior 3 years, with 56% of changes attributed to the adoption of a video laryngoscope. Other reported changes include new training methods (23%) and adoption of a checklist (10%). A video laryngoscope is available for clinical use in 89% of the responding programs. The video scope is used as the primary device in 16% and is never used in 9%. In the remainder of programs, the video laryngoscope is only used for difficult intubations or after failure of direct laryngoscopy (32%) or the primary device is determined by the preference of the operator (32%). CONCLUSIONS: The majority of internal medicine critical care program directors who recently responded to an e-mail survey reported that they have changed their approach to teaching endotracheal intubation, driven largely by the adoption of video laryngoscopy for upper airway visualization. Nevertheless, despite widespread availability, video laryngoscopy is used uncommonly as the primary visualization device for intubation at the programs represented by the respondents to this survey.
Authors: David R Janz; Matthew W Semler; Robert J Lentz; Daniel T Matthews; Tufik R Assad; Brett C Norman; Raj D Keriwala; Benjamin A Ferrell; Michael J Noto; Ciara M Shaver; Bradley W Richmond; Jeannette Zinggeler Berg; Todd W Rice Journal: Crit Care Med Date: 2016-11 Impact factor: 7.598
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