The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts

RESPIRATORY THERAPISTS CAN SUCCESFULLY SUPPORT A TEACHING INSTITUTIONS AIRWAY MANAGEMENT PROGRAM IN THE EMERGENCY DEPARTMENT.

J. Cappiello1, J. Thalman1, M. Gentile1


Background: The clinical competence of the Respiratory Therapists (RTs) as a skilled endotracheal intubator is well documented. The respiratory care department at Duke University Medical Center provides 24/7 clinical coverage in our emergency department. The role has evolved from RTs providing the majority of the tracheal intubations to one of providing training and support to the Emergency Medicine Residency program of physicians. We sought to determine success rate for endotracheal intubation by level of training and document the final intubator, if the first attempt was not successful. Our objective was to validate that the RT training of the physician staff was effective over a period of time

Method: An airway management database was maintained on 141 consecutive emergency department intubations (August 1, 2006- April 30, 2007). Data included level of training, number of laryngoscopies, number of tubes passed, number of esophageal placements, and final intubator for unsuccessful attempts.
Results: see table below

Conclusions:The number of laryngoscopy attempts required has improved over time for emergency medical residents. Intubation training done by respiratory therapists is effective in overall physician success rate. Additionally, RTs serve an integral role as the “backup” intubator in unsuccessful attempts by other personnel.

Results
Personnel Laryngoscopies/attempt Tubes passed/attempt Esophageal placement/attempt Attempted Final Intubator
1st yr MD 1.9 1.2 0.2 24 6 (RT),
3 (2nd yr)
2nd yr MD 1.8 1.3 0.3 30 10 (RT)
3rd yr MD 1.5 1.9 0.1 37 7 (RT)
Attending MD 1.1 0.9 0.1 9 N/A
RT 1.2 1.1 0.1 65 N/A



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