Document Detail


Motion capture measures variability in laryngoscopic movement during endotracheal intubation: a preliminary report.
MedLine Citation:
PMID:  22801254     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Success rates with emergent endotracheal intubation (ETI) improve with increasing provider experience. Few objective metrics exist to quantify differences in ETI technique between providers of various skill levels. We tested the feasibility of using motion capture videography to quantify variability in the motions of the left hand and the laryngoscope in providers with various experience.
METHODS: Three providers with varying levels of experience [attending physician (experienced), emergency medicine resident (intermediate), and postdoctoral student with no previous ETI experience (novice)] each performed ETI 4 times on a mannequin. Vicon, a 16-camera system, tracked the 3-dimensional orientation and movement of markers on the providers, handle of the laryngoscope, and mannequin. Attempt duration, path length of the left hand, and the inclination of the plane of the laryngoscope handle (mean square angular deviation from vertical) were calculated for each laryngoscopy attempt. We compared interattempt and interprovider variability of each measure.
RESULTS: All ETI attempts were successful. Mean (SD) duration of laryngoscopy attempts differed between experienced [5.50 (0.68) seconds], intermediate [6.32 (1.13) seconds], and novice [12.38 (1.06) seconds] providers (P = 0.021). Mean path length of the left hand did not differ between providers (P = 0.37). Variability of the plane of the laryngoscope differed between providers: 8.3 (experienced), 28.7 (intermediate), and 54.5 (novice) degrees squared.
CONCLUSIONS: Motion analysis can detect interprovider differences in hand and laryngoscope movements during ETI, which may be related to provider experience. This technology has potential to objectively measure training and skill in ETI.
Authors:
Jestin N Carlson; Samarjit Das; Fernando De la Torre; Clifton W Callaway; Paul E Phrampus; Jessica Hodgins
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Simulation in healthcare : journal of the Society for Simulation in Healthcare     Volume:  7     ISSN:  1559-713X     ISO Abbreviation:  Simul Healthc     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-08-06     Completed Date:  2012-12-31     Revised Date:  2013-08-12    
Medline Journal Info:
Nlm Unique ID:  101264408     Medline TA:  Simul Healthc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  255-60     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, University of Pittsburgh, PA 15213, USA. carlsonjn@upmc.edu
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MeSH Terms
Descriptor/Qualifier:
Biomechanics
Clinical Competence
Educational Status
Feasibility Studies
Humans
Intubation, Intratracheal / instrumentation,  methods*
Laryngoscopy / education*,  instrumentation
Motion*
Time Factors
United States
Video Recording*
Grant Support
ID/Acronym/Agency:
1K12HL109068-01/HL/NHLBI NIH HHS; 5U01HL077871-07/HL/NHLBI NIH HHS; K12 HL109068/HL/NHLBI NIH HHS; U01 HL077871/HL/NHLBI NIH HHS
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