The Effectiveness of a Short Training Course for Emergency Medicine Residents to Confirm Tracheal Tube Placement by Ultrasound



Afzalimoghaddam M¹ ; Basiri K¹ ; Seyedhosseinidvarani S¹ ; Bagheri F¹ ; Karimialavijeh E¹ Show Affiliations
Source: Critical Care and Shock Published:2019

Abstract

Objective: The present study aimed to evaluate the performance of tracheal ultrasound by novice emergency medicine residents after participating in a short training course. Methods: This was an observational prospective study conducted between July 2016 and September 2017 at three university-affiliated emergency departments in Tehran, Iran. Adult patients (over 18 years of age) who needed emergency intubation were included. Investigators were emergency medicine residents who did not have prior experience in tracheal ultrasound. Training course consisted of 40 minutes of theoretical education and three days of hands-on training. Immediately after intubation by treating physicians, two investigators evaluated the placement of the tracheal tube simultaneously. One investigator used tracheal ultrasound and the second investigator used quantitative wave form capnography. The registrant was a nurse who was asked to record the results of each investigator in the following format: 1. Correct tracheal intubation, 2. Esophageal intubation, and 3. Time spent to complete the evaluation. Finally, the ultrasound results were compared with those of capnography. Results: Ninety patients were included in the study. Based on the capnography results, there were three (3.3%) esophageal intubations and 87 (96.6%) tracheal intubations. Investigators reported the same results by tracheal ultrasound. The mean±SD time spent to complete the evaluation was 32±10 seconds for capnography and 48±15 seconds for tracheal ultrasound (p value of 0.0001). Conclusion: Emergency medicine residents with basic knowledge of ultrasound can learn tracheal ultrasound techniques through a short training course. © 2019, The Indonesian Foundation of Critical Care Medicine. All rights reserved.