Video Versus Direct Laryngoscopy on Intubation Success Rates in the SRNA

Abstract

General anesthesia can be supported by placing an endotracheal tube through the trachea to provide oxygenation, ventilatory support, and deliver inhaled anesthetics. Two common modes of endotracheal intubation consist of Direct Laryngoscopy (DL) or Video Laryngoscopy (VL). Studies have shown that intubation has been associated with patient complications such as airway trauma and repeated or prolonged attempts at intubation may increase the risks of more severe complications such as hypoxia, hemodynamic instability, cardiac arrest, and death. As novice anesthesia providers, student registered nurse anesthetists (SRNAs) are in the beginning processes of mastering this skill while still maintaining patient safety. Over a 3-month period, first-year SRNAs at AdventHealth University were voluntarily asked to report which tool was used for each intubation and whether the intubation was successful. The Wilcoxon signed-rank test was used to analyze this data. The project’s aim was achieved, which demonstrated a significant difference in median success rate between the two methods. Over the 3-month study period, intubation success with VL was greater than that of DL. In the first month of the study, participants utilized the VL far more than the DL and were more successful with intubating with the VL. By the third month of the study, participants began utilizing the DL more frequently and had greater success when compared to the first month. This demonstrates that VL improves SRNAs intubation success, aids in recognizing pertinent airway anatomy, knowledge, and supports a culture change to one where the use of VL in the SRNA is encouraged.

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