BACKGROUND:
For novice providers, achieving competency in neonatal intubation is becoming increasingly difficult, possibly because of fewer intubation opportunities. In the present study, we compared intubation outcomes on manikins using direct laryngoscopy (DL), indirect video laryngoscopy (IVL) using a modified disposable blade, and augmented reality–assisted video laryngoscopy (ARVL), a novel technique using smart glasses to project a magnified video of the airway into the intubator’s visual field.
METHODS:
Neonatal intensive care nurses (n = 45) with minimal simulated intubation experience were randomly assigned (n = 15) to the following 3 groups: DL, IVL, and ARVL. All participants completed 5 intubation attempts on a manikin using their assigned modalities and received verbal coaching by a supervisor, who viewed the video while assisting the IVL and ARVL groups. The outcome and time of each attempt were recorded.
RESULTS:
The DL group successfully intubated on 32% of attempts compared to 72% in the IVL group and 71% in the ARVL group (P < .001). The DL group intubated the esophagus on 27% of attempts, whereas there were no esophageal intubations in either the IVL or ARVL groups (P < .001). The median (interquartile range) time to intubate in the DL group was 35.6 (22.9–58.0) seconds, compared to 21.6 (13.9–31.9) seconds in the IVL group and 20.7 (13.2–36.5) seconds in the ARVL group (P < .001).
CONCLUSIONS:
Simulated intubation success of neonatal intensive care nurses was significantly improved by using either IVL or ARVL compared to DL. Future prospective studies are needed to explore the potential benefits of this technology when used in real patients.
Two hundred soldiers of the Sri Lanka Army who had undergone vasectomy at least 4 years earlier were interviewed by a pretested questionnaire to determine the incidence and nature of any changes in sexual behaviour after the operation. Fifty-six percent reported some change in their sexual behaviour after vasectomy. A decreased frequency of intercourse being reported by 15%, a decreased sexual desire by 19% and changes in sexual behaviour during intercourse by 33%. Seven percent reported that their wives had noticed an alteration in sexual behaviour after operation. In spite of these changes in sexual behaviour after vasectomy the majority of men (92%) reported satisfaction with the operation, which is an indication that changes in sexual behaviour cannot be attributed directly to vasectomy.
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