Downward Trend in Pediatric Resident Laryngoscopy Participation in PICUs

Gabrani, Aayush; Kojima, Taiki; Sanders, Ronald C.; Shenoi, Asha; Montgomery, Vicki; Parsons, Simon; Gangadharan, Sandeep; Nett, Sholeen; Napolitano, Natalie; Tarquinio, Keiko M.; Simon, Dennis; Lee, Anthony; Émériaud, Guillaume; Adu‐Darko, Michelle; Giuliano, John S.; Meyer, Keith; Graciano, Ana Lía; Turner, David A.; Krawiec, Conrad; Bakar, Adnan; Polikoff, Lee; Parker, Margaret M.; Harwayne‐Gidansky, Ilana; Crulli, Benjamin; Vanderford, Paula A.; Breuer, Ryan; Gradidge, Eleanor; Branca, Aline; Grater-Welt, Lily B.; Téllez, David; Wright, Lisa V.; Pinto, Matthew; Nadkarni, Vinay; Nishisaki, Akira

doi:10.1097/pcc.0000000000001470

Cited by 24 publications

(23 citation statements)

References 33 publications

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“…We believe our study has serious implications for the field of PCCM. There has been a decrease over time in the number procedures performed by residents ( 6 , 7 ) well as by PCCM fellows ( 1 ). We have now demonstrated a decrease over time in procedures per admission for a large cohort of pediatric critical care units in the United States and Canada.…”

Section: Discussionmentioning

confidence: 99%

Declining Procedures in Pediatric Critical Care Medicine Using a National Database

Ross

Engorn

Newth

et al. 2021

Critical Care Explorations

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Section: Discussionmentioning

confidence: 99%

Declining Procedures in Pediatric Critical Care Medicine Using a National Database

Ross

Engorn

Newth

et al. 2021

Critical Care Explorations

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“…This seems to be a universal tendency, with a higher proportion of intubations performed by fellows from pediatric intensive care units in the United States over the past decade. [ 19 ]…”

Section: Discussionmentioning

confidence: 99%

Changing the view: Video versus direct laryngoscopy for intubation in the pediatric emergency department

Couto¹,

Reis²,

Farhat³

et al. 2020

Medicine

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The aim of this study was to compare the success of first-attempt tracheal intubation in pediatric patients >1-year old performed using video versus direct laryngoscopy and compare the frequency of tracheal intubation–associated events and desaturation among these patients. Prospective observational cohort study conducted in an Academic pediatric tertiary emergency department. We compared 50 children intubated with Mcgrath Mac video laryngoscope (VL group) and an historical series of 141 children intubated with direct laryngoscopy (DL group). All patients were aged 1 to 18 years. The first attempt success rates were 68% (34/50) and 37.6% (53/141) in the VL and DL groups ( P < .01), respectively. There was a lower proportion of tracheal intubation–associated events in the VL group (VL, 31.3% [15/50] vs DL, 67.8% [97/141]; P < .01) and no significant differences in desaturation (VL, 35% [14/50] vs DL 51.8% [72/141]; P = .06). The median number of attempts was 1 (range, 1–5) for the VL group and 2 (range, 1–8) for the DL group ( P < .01). Multivariate logistic regression showed that video laryngoscope use was associated with higher chances of first-attempt intubation with an odds ratio of 4.5 (95% confidence interval, 1.9–10.4, P < 0.01). Compared with direct laryngoscopy, VL was associated with higher success rates of first-attempt tracheal intubations and lower rates of tracheal intubation–associated events.

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“…For example, in the case of endotracheal intubation, the number of intubations performed in large academic centers by residents in the delivery room or N/IICU and pediatric intensive care unit is relatively low and decreasing, respectively. 13 , 14 The opportunity to achieve specific communication goals (eg, leading family meetings, delivering bad news) is likely related to the type of patients the resident cares for during their rotation and appropriateness of opportunities for such learning experiences.…”

Section: Discussionmentioning

confidence: 99%

Improving the Resident Educational Experience in a Level IV Neonatal/Infant Intensive Care Unit

Handley

Pouppirt

Zucker

et al. 2020

Pediatric Quality &Amp; Safety

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Downward Trend in Pediatric Resident Laryngoscopy Participation in PICUs

Abstract: Laryngoscopy by pediatric residents has substantially decreased over time. This downward trend was not associated with the 2013 Accreditation Council for Graduate Medical Education change in residency requirements.

Cited by 24 publications

References 33 publications

Declining Procedures in Pediatric Critical Care Medicine Using a National Database

Declining Procedures in Pediatric Critical Care Medicine Using a National Database

Changing the view: Video versus direct laryngoscopy for intubation in the pediatric emergency department

Improving the Resident Educational Experience in a Level IV Neonatal/Infant Intensive Care Unit

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