ABSTRACT
OBJECTIVE: To assess training in blind intubation with the Fastrach laryngeal mask in a simulation model by applying the cumulative sums (CuSum) method. MATERIAL AND METHODS: Six anaesthesiology resident doctors, with no previous experience of the technique, participated, three in their first year, and three in the second. The study was conducted with the help of the SimMan Universal Simulator. Fifty attempts by each one of them over a four month period, divided into two stages: the first 20 with minimum airway difficulty, and the next 30 with limitations of flexion-extension movements to <80°. An unacceptable failure rate was set at 10% after a second failed attempt. The time limit set to be considered a success was 60seconds. RESULTS: A total of 120 attempts in the first stages, and the remaining 180 in the second were analysed individually, all managing to achieve acceptable success rates of 90%: 84% in the first attempt and 13.33% in the second. A total of 2.66% failures were recorded. The learning curve showed that the residents began to achieve an acceptable 90% success rate in case number 25±11.76 of the 50 attempts. CONCLUSIONS: This statistical method and the SimMan simulator, used together, have demonstrated to be very useful tools in assessing learning curves in this technique.
Subject(s)
Anesthesiology/education , Laryngeal Masks , Learning Curve , Manikins , Humans , Internship and ResidencyABSTRACT
Objetivos: Evaluar el aprendizaje de intubación a ciegas a través de mascarilla laríngea Fastrach en un modelo de simulación, mediante la aplicación del método de sumas acumulativas CuSum. Material y métodos: Participaron seis médicos residentes de Anestesiología, tres en su primer año y tres en el segundo, sin experiencia previa en la técnica. El estudio se realizó con la ayuda del Simulador Universal SimMan. A lo largo de 4 meses, se registraron 50 intentos en cada uno de ellos, divididos en dos etapas: los primeros 20 con mínima dificultad de vía aérea y los siguientes 30 con limitación a los movimientos de flexoextensión a < 80°. Se aceptó como índice inaceptable de fallo el 10% tras un segundo intento fallido. El límite temporal fijado para considerarlo éxito fue de 60 s. Resultados: Se analizaron 120 intentos en la primera etapa y los 180 restantes en la segunda, individualmente; todos lograron unos índices aceptables de éxito del 90%: el 84% en el primer intento y el 13,33% en el segundo. Se registró un 2,66% de fallos del total. La curva de aprendizaje mostró que los residentes lograron alcanzar el índice aceptable de éxito del 90% como media en el caso número 25 ± 11,76, de 50 casos. Conclusiones: Se ha demostrado que este método estadístico y el simulador SimMan utilizados conjuntamente son unas herramientas muy útiles en la evaluación del aprendizaje de esta técnica(AU)
Objective: To assess training in blind intubation with the Fastrach laryngeal mask in a simulation model by applying the cumulative sums (CuSum) method. Material and methods: Six anaesthesiology resident doctors, with no previous experience of the technique, participated, three in their first year, and three in the second. The study was conducted with the help of the SimMan Universal Simulator. Fifty attempts by each one of them over a four month period, divided into two stages: the first 20 with minimum airway difficulty, and the next 30 with limitations of flexion-extension movements to <80°. An unacceptable failure rate was set at 10% after a second failed attempt. The time limit set to be considered a success was 60 seconds. Results: A total of 120 attempts in the first stages, and the remaining 180 in the second were analysed individually, all managing to achieve acceptable success rates of 90%: 84% in the first attempt and 13.33% in the second. A total of 2.66% failures were recorded. The learning curve showed that the residents began to achieve an acceptable 90% success rate in case number 25±11.76 of the 50 attempts. Conclusions: This statistical method and the SimMan simulator, used together, have demonstrated to be very useful tools in assessing learning curves in this technique(AU)
