Comparison Between Direct Laryngoscopy and Video Laryngoscopy for Neonatal Intubation. Confidence of Staff and Number of Attempts to Successful Intubation
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Respiratory Distress Syndrome
- Sponsor
- Royal Devon and Exeter NHS Foundation Trust
- Enrollment
- 39
- Locations
- 1
- Primary Endpoint
- Number of attempts to successful intubation
- Status
- Completed
- Last Updated
- 7 years ago
Overview
Brief Summary
Our research questions are
- Will the use of a video laryngoscope lead to decreased attempts
- Does this result in more successful intubations and greater confidence in the supervisor and the team that a successful intubation has been performed.
Detailed Description
Neonatal intubation is a technically difficult, but essential, skill to learn, involving passing a plastic tube through the vocal cords, into the trachea. Current practice involves using a laryngoscope to directly visualise the cords, however this technique does not allow the supervisor to witness the tube passing through the cords. Video laryngoscopes have a camera at the distal end of the blade, allowing an 85% viewing angle as opposed to 15% that is seen with direct view. In addition, the image is projected onto a screen, allowing all members of the team to visualise the intubation and therefore provide real time guidance as well as increased confidence in the outcome of the attempt. Video laryngoscopes are used in neonates in other specialities, for example Ear Nose and throat or respiratory physicians, and are becoming routinely used by neonatologists. The research questions are whether using a video laryngoscope will lead to decreased attempts, which in turn will potentially result in more successful intubations and greater confidence in the supervisor and the team that a successful intubation has been performed. The aim is to recruit 40 babies and randomly allocate the participant to either direct laryngoscopy or video laryngoscopy for elective intubations. Number of attempts to successful intubation would be recorded, in addition to confidence of supervisor and the team regarding the outcome of the attempt.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Any baby requiring intubation on a neonatal unit
Exclusion Criteria
- •Infants will not be recruited if they are in extremis requiring immediate intubation by a senior experienced operator who will use his/her own preferred method. Infants who will be intubated nasally will not be included as this technique is not usually taught to registrars.
- •Any baby with a congenital airway malformation will not be included in the study
Outcomes
Primary Outcomes
Number of attempts to successful intubation
Time Frame: Each attempt is defined by the need to stop the attempt and give non-invasive support. A maximum of 3 attempts per trainee. The eligible participant is any baby on NNU who requires intubation
How many attempts before successful intubation
Team confidence around tube placement at the time of tube placement
Time Frame: immediately after the intubation
Continuous line to score the confidence of the individuals in the team