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.
|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)|