Telepresent Intubation Supervision Is as Effective as In-Person Supervision of Procedurally Naive Operators.
No Thumbnail Available
Date
2014-12-09
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Abstract Background Telepresence is emerging in clinical and educational settings as a potential modality to provide expert guidance during remote airway management This study aimed to compare the effectiveness of telepresent versus in person supervision of tracheal intubation Materials and Methods A randomized crossover study was performed in a university medical simulation center with 48 first and second year medical students with no formal procedural training in tracheal intubation Each participant was assigned to receive each of four study arms in random sequence 1 direct laryngoscopy DL with in person supervision 2 DL with telepresent supervision 3 videolaryngoscopy VL with in person supervision and 4 VL with telepresent supervision Telepresence was established with a smartphone Apple Cupertino CA iPhone via FaceTime connection The primary outcome measure was the time to successful intubation Secondary outcome measures included first pass success rate and the number of blade and tube attempts Results There was no significant difference between in person and telepresent supervision for any of the outcomes The median difference in person versus telepresent for time to intubation was 3 s 95 confidence interval CI 20 to 14 s The odds ratio for first attempt success was 0 7 95 CI 0 3 1 3 and the rate ratio for extra number of blade attempts i e attempts in addition to first was 1 1 95 CI 0 7 1 7 and 1 4 95 CI 0 9 2 2 for extra number of tube attempts Conclusions In this study population of procedurally naive medical students telepresent supervision was as effective as in person supervision for tracheal intubation