Success of Pediatric Anesthesiologists in Learning to Use Videolaryngoscopes

Study Overview
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Brief Summary
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There are two new instruments on the market that anesthesiologists use when putting a breathing tube into the lungs of patients. The purpose of this study is to see how easily anesthesiologists can learn to use them in children.

Detailed Description
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Each anesthesiologist performed 20 timed baseline intubations. They were then randomized to perform 20 timed intubations with one of the two new videolaryngoscopes followed by 20 with the other new videolaryngoscope. The goal was to see how quickly they could become proficient.

Official Title
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Anesthesiologists Learning to Use Videolaryngoscopes in Children

Conditions
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Tracheal Intubation Morbidity

Intervention / Treatment
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* Procedure: timed intubation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria for Children Population: - Children requiring intubation for elective or non-elective surgery Exclusion Criteria: Children with raised intracranial pressure Children with potential cervical spine injuries Children at risk for regurgitation because of a full stomach Children who were anticipated to have a difficult airway based on their physical appearance or previous experience were excluded. Inclusion Criteria for Anesthesiologist Population: *Anesthesiologists who care for children at Stollery Children's Hospital Exclusion Criteria for Anesthesiologist Population: *None

Ages Eligible for Study
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Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| children intubated with Glidescope<br>children intubated with Glidescope | Procedure: timed intubation<br>* timed intubation<br>|
| children intubated with DCI<br>children intubated with DCI | Procedure: timed intubation<br>* timed intubation<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Success in Learning to Use a Videolaryngoscope(VLS) | Anesthesiologists were to perform 20 intubations with each videolaryngoscopes. #1-10 were for practice. Rapid Success was no failed intubation attempts on #11-20 and a median time-to-intubation no more than 50% longer than their baseline median time-to-intubation on #11-15 . Delayed Success was achieving these same parameters on #16-20 if they were not achieved on #11-15. Operators who did not achieve either goal were labeled as having No Success. | Up to 5 minutes per intubation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cormack & Lehane Score | This Outcome was designed to determine if the view of the airway as determined by the Cormack & Lehane grading system is improved by use of the GlideScope (GS) video laryngoscope and/or the Karl Storz Direct Coupled Interface (DCI) (KS) video laryngoscope as this would be a surrogate marker for utility in a difficult airway. Score is reported as a whole number from I to IV with I being an easy intubation and IV being one where the larynx cannot be visualized at all. | reported during intubation (up to 5 minutes) | 
| Time to Intubation, Analyzed by Order of Laryngoscopes Used | To determine if the learning curve was altered by the order in which the two new laryngoscopes were learned by the anesthesiologist,mean and median times on intubations #16-20 were compared for the two videolaryngoscopes. | 4 years | 
| Time to Intubation, Stratified by Weight of Patients | To compare the time-to-intubation for these laryngoscopes in children of different weights. | 4 years | 
| Mean Years Since Completion of Anesthesiology Residency | To investigate whether there was a correlation between the years since completion of anesthesiology residency to the mid-point of study (2008)and median time-to-intubation for all first attempt intubations for the study. Years since completion of anesthesiology residency reported in the data table, correlation reported in the statistical analysis below | Baseline (assessed as of 2008) | 
| Number of Intubation Attempts to Reach Best Obtainable Time to Intubation | For each anesthesiologist, the median time-to-intubation for patients #1-5, #6-10, #11-15, and #16-20 was determined. The anesthesiologist was considered to have reached Best Obtainable Time (BOT) to Intubation once the median time on any group of 5 consecutive patients was less than 3 seconds faster than the median time in the previous group of 5 consecutive patients, provided that there were no failed intubations or subsequent failed intubations using the same device. | less than 5 minutes per intubation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Surgical procedures, Intubation, Anesthesiologist, Laryngoscope, Videolaryngoscope