Learning Curves for Bag-and-mask Ventilation and Orotracheal Intubation

Komatsu, Ryu; Kasuya, Yuko; Yogo, Hisanori; Sessler, Daniel I.; Mascha, Edward J.; Yang, Dongsheng; Ozaki, Makoto

doi:10.1097/aln.0b013e3181d96779

Cited by 98 publications

(94 citation statements)

References 20 publications

(26 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The CUSUM method has been used in many studies investigating the acquisition of competence or assessment of performance in anesthesia technical skills, 22,25,[28][29][30][31] and it has been used more recently in ultrasound-guided procedures. 21,23,24,26,32 It can be used to show proficiency in a newly learned technical skill or measure quality once a technical skill has been mastered.…”

Section: Discussionmentioning

confidence: 99%

Anesthesiologists’ learning curves for bedside qualitative ultrasound assessment of gastric content: a cohort study

Arzola

Carvalho

Cubillos

et al. 2013

Can J Anesth/J Can Anesth

108

View full text Add to dashboard Cite

Purpose Focused assessment of the gastric antrum by ultrasound is a feasible tool to evaluate the quality of the stomach content. We aimed to determine the amount of training an anesthesiologist would need to achieve competence in the bedside ultrasound technique for qualitative assessment of gastric content. Methods Six anesthesiologists underwent a teaching intervention followed by a formative assessment; then learning curves were constructed. Participants received didactic teaching (reading material, picture library, and lecture) and an interactive hands-on workshop on live models directed by an expert sonographer. The participants were instructed on how to perform a systematic qualitative assessment to diagnose one of three distinct categories of gastric content (empty, clear fluid, solid) in healthy volunteers. Individual learning curves were constructed using the cumulative sum method, and competence was defined as a 90% success rate in a series of ultrasound examinations. A predictive model was further developed based on the entire cohort performance to determine the number of cases required to achieve a 95% success rate. Results Each anesthesiologist performed 30 ultrasound examinations (a total of 180 assessments), and three of the six participants achieved competence. The average number of cases required to achieve 90% and 95% success rates was estimated to be 24 and 33, respectively. Conclusion With appropriate training and supervision, it is estimated that anesthesiologists will achieve a 95% success rate in bedside qualitative ultrasound assessment after performing approximately 33 examinations. RésuméObjectif L'évaluation ciblée de l'antre pylorique par échographie est un outil utile pour estimer la qualité du contenu de l'estomac. Notre objectif était de déterminer la quantité de formation nécessaire à un anesthésiologiste afin d'acquérir des compétences en échographie au chevet pour l'évaluation qualitative du contenu gastrique. Méthode Six anesthésiologistes ont suivi une formation, puis une évaluation formative; des courbes d'apprentissage ont ensuite été élaborées. Les participants ont reçu un enseignement didactique (matériel de lecture, bibliothèque d'images, et cours) et suivi un atelier pratique interactif sur

show abstract

Section: Discussionmentioning

confidence: 99%

Anesthesiologists’ learning curves for bedside qualitative ultrasound assessment of gastric content: a cohort study

Arzola

Carvalho

Cubillos

et al. 2013

Can J Anesth/J Can Anesth

108

View full text Add to dashboard Cite

show abstract

“…This could result in a deterioration in the cusum curve, as failures are more likely because of increasing procedural difficulty despite no change in skill level. 5 As described previously, Komatsu 24 risk adjusted the cusum score for airway management, showing that this can be achieved successfully. It is however a single study, with a small sample population which has not been validated.…”

Section: Discussionmentioning

confidence: 64%

“…This applies even to basic skills like cannulation, as the interns in de Oliveira Filho's study 4 required between 19-146 attempts to achieve competency, despite the fact they were allowed to miss 20% of the cannulas! Komatsu's group 24 performed an interesting additional analysis in their trial. Airway management was risk stratified by grading the likelihood of difficulties in bag-mask ventilation and tracheal intubation.…”

Section: Airway and Cannulation Skillsmentioning

confidence: 99%

Assessment of procedural skills training and performance in anesthesia using cumulative sum analysis (cusum)

Starkie

Drake

2013

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Assessment of procedural skills training and performance in anesthesia using cumulative sum analysis (cusum) É valuation de la formation en habiletés techniques et de la performance en anesthésie au moyen de l'analyse des sommes cumulées (cusum) Abstract Purpose The current methods (work based assessments and logbooks) used to assess procedural competency and performance have well-documented deficiencies. Cumulative sum analysis (cusum), a statistical method that generates performance graphs over time, is an alternative tool that is not currently widely used. The purpose of this review is to investigate its current role in anesthetic procedural skills training and performance.Tim

show abstract

“…[6] A study of interns also reported more variable rates to learn the skill compared to bag and mask ventilation. [7] We did not find any research on intubation in emergency in Nepal. Nepal is a resource constraint setting.…”

mentioning

confidence: 98%

Endotracheal Intubation in Emergency- An Experience From Eastern Nepal

Gupta¹,

Bhandari²

2017

jemds

View full text Add to dashboard Cite

show abstract

Learning Curves for Bag-and-mask Ventilation and Orotracheal Intubation

Abstract: Participating interns developed mask ventilation skills faster than orotracheal intubation skills, and there was more variability in the rate at which intubation skills developed. A median of 29 procedures was required to achieve an 80% orotracheal intubation success rate.

Cited by 98 publications

References 20 publications

Anesthesiologists’ learning curves for bedside qualitative ultrasound assessment of gastric content: a cohort study

Anesthesiologists’ learning curves for bedside qualitative ultrasound assessment of gastric content: a cohort study

Assessment of procedural skills training and performance in anesthesia using cumulative sum analysis (cusum)

Endotracheal Intubation in Emergency- An Experience From Eastern Nepal

Contact Info

Product

Resources

About