| Teaching airway management to novices: a simulator manikin study comparing the 'sniffing position' and 'win with the chin' analogies. | |
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MedLine Citation:
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PMID: 20167582 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The 'sniffing position' is widely promoted for teaching airway positioning before intubation, but whether this analogy results in novices placing the head and neck appropriately has not been evaluated. We compared performance following the sniffing position instructions with an alternate analogy, 'win with the chin'. We also compared performance following simple anatomic instructions and no instructions. METHODS: A randomized controlled study of medical students and PGY1 registrars in Surgery and Internal Medicine was performed. Subjects independently positioned a simulator manikin head and neck based upon their understanding of four written instructions in random order: (i) the 'sniffing position'; (ii) the 'win with the chin' analogy, (iii) anatomic instructions; and (iv) no instructions (control). Digital photographs following each instruction were analysed by two airway experts for (i) adequacy of overall positioning and (ii) the three components of airway positioning. RESULTS: Eighty-one volunteers participated. The positioning was adequate most often (43.2%) following the 'win with the chin' analogy when compared with the other instructions (37.0% anatomic instructions; 19.8% control; 14.8% 'sniffing position' analogy). Positioning following the 'sniffing position' instructions was not different from no instruction (P=0.53). The 'win with the chin' and anatomic instructions were significantly better than no instructions (P=0.002 and 0.023, respectively). CONCLUSIONS: The 'win with the chin' analogy resulted in adequate airway positioning significantly more often than the 'sniffing position' or control. It also maintained atlanto-occipital extension compared with anatomic instructions. Overall, 'win with the chin' was a superior teaching analogy and could replace the 'sniffing position' analogy. |
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Authors:
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P G Brindley; M R Simmonds; C J Needham; K A Simmonds |
Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial Date: 2010-02-18 |
Journal Detail:
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Title: British journal of anaesthesia Volume: 104 ISSN: 1471-6771 ISO Abbreviation: Br J Anaesth Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-03-15 Completed Date: 2010-04-14 Revised Date: 2010-12-01 |
Medline Journal Info:
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Nlm Unique ID: 0372541 Medline TA: Br J Anaesth Country: England |
Other Details:
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Languages: eng Pagination: 496-500 Citation Subset: IM |
Affiliation:
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University of Alberta, Edmonton, Canada. peter.brindley@albertahealthservices.ca |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anesthesiology
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education* Chin Clinical Competence Education, Medical / methods* Head Movements Humans Intubation, Intratracheal / methods*, standards Manikins Patient Positioning / methods*, standards Terminology as Topic |
| Comments/Corrections | |
Comment In:
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Br J Anaesth. 2010 Jul;105(1):93; author reply 93-4
[PMID:
20551031
]
Br J Anaesth. 2010 Dec;105(6):874 [PMID: 21081689 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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