2006 OPEN FORUM Abstracts
Impact of a Virtual Education and Simulation Technology (VEST) Lab on Respiratory Care Practitioner Intubation Performance with Patients
Francis Gott III, AS, RRT; John Emberger, BS, RRT; Charles Fort, RN, MSN,
Departments of Respiratory Care and Academic Affairs, Christiana Care Health
System, Newark DE.
Background: Respiratory Care Practitioners (RCPs) at Christiana Care Health System (CCHS) maintain
certification as part of our intubation team. RCPs
are the first line intubators at code and emergent situations. CCHS has two
facilities: one with 24 hour anesthesia staff coverage (facility 1) and another
(facility 2) with less than 24 hour anesthesia staff coverage. The RCPs who work in facility 2 are called to intubate patients
with difficult airways more frequently than RCPs in
facility 1. RCPs that work in facility 2 were selected to
attend a Virtual Education and Simulation Technology (VEST) lab session using a
METI Human Patient Simulator. A VEST lab session with nine difficult airway
scenarios was incorporated into RCPs (at facility 2)
training to help maintain and/or improve intubation skills. The current study was designed to evaluate
the effectiveness of simulation lab training on intubation performance.
Method: We examined two years (2005-2006) of our department intubation log of actual
patient intubations. We collected all successful and failed intubations of the RCPs who attended the VEST lab session, as well as RCPs who did not attend a VEST lab session.
Results: Fourteen RCPs attended the VEST lab session. Eighty
intubations were identified as performed by RCPs who
attended the VEST lab session. Thirty-five were pre-VEST lab and forty-five
were post-VEST lab. One hundred thirty-six
intubations were identified as performed by RCPs who
did not attend the VEST lab (non-VEST Lab RCPs). The
table shows the success rates of intubations.
| # Failed Intubations | # successful Intubations | % Attempts Successful | |
| Non-VEST Lab RCPs | 17 | 119 | 88% |
| RCPs Pre-VEST Lab | 6 | 29 | 83% |
| RCPs Post-VEST Lab | 4 | 41 | 91% |
| Overall | 27 | 189 | 88% |
Conclusions: The
success rate of the RCPs improved after attending the
VEST lab (83% pre versus 91% post). The RCPs chosen to attend the VEST lab may have attempted more
difficult intubations because they are in a facility without 24 hour anesthesia
coverage. This would explain the initial success rate of 83% as opposed to the
initial 88% success rate of non-VEST lab RCPs. Using VEST
lab sessions for intubation and difficult airway training may be a valuable way
to improve and maintain intubation skills.