THE EFFICACY OF A STANDARD TRAINING-PROGRAM FOR TRANSILLUMINATION-GUIDED ENDOTRACHEAL INTUBATION

Objective: To evaluate the success rate, intubation time, and complica tion rate of transillumination-guided intubation following two hours o f instruction in the use of the Trachlight (TL) device. Methods: A pro spective, randomized crossover laboratory trial was conducted at an em ergency medical service training site with 30 nonpaid volunteer parame dic students, one month prior to their graduation. The students were i nstructed in the use of the TL in a standardized curriculum consisting of didactic, video, and demonstration sessions. Each student was requ ired to successfully intubate a training manikin with the TL five time s. Approximately three weeks later, the students were asked to intubat e the manikin 20 times, alternating between direct laryngoscopy (DL) a nd TL. Results: The success rates were 94% for DL and 63% for TL (p < 0.0001). The mean intubation times were 14.6 seconds for DL and 16.8 s econds for TL (p < 0.001). The incidences of trauma were 7.3% for DL a nd 1.4% for TL (p < 0.001). Conclusion: A two-hour training session, i ncluding five successful light-guided intubations using the TL, was in adequate for producing acceptable success rates during manikin intubat ions by paramedic students. While TL intubation intervals were shorter when successful, the 2.2-second difference was not clinically meaning ful. The incidence of trauma in our manikin model during TL intubation s was significantly lower than that with DL.