Simulation learning in the emergency department: Impact on VideoLaryngoscope Intubation Skills

Introduction In the emergency department (ED), learning by simulation provides a safe acquisition of procedural skills. This study’s objective was to evaluate the impact of the simulation-based learning on videolaryngoscope (VL) orotracheal intubation (OTI) skills among residents practicing in ED. Methods: evaluative, prospective study, including residents practicing in teaching hospitals ED in Tunis. They were novices in direct laryngoscopy. We scheduled a procedural simulation session. Residents were evaluated before and after the session. The primary endpoint was the rate of successful OTI after learning session. Results: 32 residents were enrolled. The mean age was 28 ± 2.5 years. Gender ratio was 0.18. The mean exercise seniority was 1.53 ± 0.7 years. The rate of successful OTI before and after the training was observed in 4 residents (12.5%) vs 23 (71.8), p=0.689. The   average time of OTI was respectively 149.81±108 seconds (sec) vs. 51±96 sec (p<0.001). The rate of esophageal intubation was n (%): 16 (50%) vs 9 (28%) (p=0.49) and the mean number of attempts was 3.81 vs. 1.84 (p<0.001). Intubation time after the session more than 12 sec was an independent factor of intubation failure (Adjusted OR= 3.5, p=0.001 and 95%CI [1.018-10.69]).  Conclusion:  Learning by simulation in the ED provides residents with a skill that allows  complete OTI in less time and a smaller number of attempts. Intubation time is an independent factor predicting intubation failure among doctors learning intubation by VL.