ABSTRACT
Introduction and objectives
There are multiple approaches to teach residents the skill of endotracheal intubation, including classroom teaching, cadaveric specimens, and simulation mannequins. The hypothesis of our study is training in the technique of intubation is equally mastered (resident confidence and competency) in training on human cadavers or simulation mannequins.
Materials and methods
Emergency medicine interns were asked to voluntarily enroll in the study prior to the beginning of intern year and randomized into two groups. The first group practiced intubation using mannequins. The second group practiced intubation using human cadavers. Both groups were given the same brief introductory lecture on the basics of endotracheal intubation. One week later, all the interns returned and attempted to intubate cadavers and mannequins. Competency assessment was based on the number of successful intubations, number of attempts, and use of adjunctive techniques. Interns were also surveyed after their anesthesia rotation with a Likert scale on confidence of being able to perform intubation.
Results
The overall average number of attempts was 1.67 in the mannequin group and 1.85 in the cadaver group. Mannequin trained interns had a total of 24 poor techniques noted over the 2 years. The cadaver trained group had a total of 35 poor techniques over the 2 years. Adjunct use was nearly identical in the two groups. Intubation success rate during anesthesia rotation and preparation ratings were nearly identical in the two groups. However, the cadaver-trained group reported feeling slightly more confident.
Conclusion
Overall, mannequins require fewer attempts to intubate and being mannequin trained results in fewer attempts. Adjunct use is independent of training type. The mannequintrained group had less episodes of poor technique than the cadaver-trained group. A mannequin training appears to be equivalent or better than cadaveric training for securing an airway, although cadaver trained interns reported slightly more confidence.
How to cite this article
Rothstein J, Gullo J, Cuningham L, Murphy P, Sochor M. Training Emergency Medicine Residents— the Skill of Endotracheal Intubation: Comparison of Human Cadavers vs Mannequins. Panam J Trauma Crit Care Emerg Surg 2014;3(1):8-10.
A call for collaboration and consensus on training for endotracheal intubation in the medical intensive care unit
