Board 303 - Research Abstract Videolaryngoscope Versus Classic Laryngoscope in Teaching Neonatal Endotracheal Intubation
Bibliographic record
Abstract
Introduction/Background Pediatricians acquire the skill of neonatal endotracheal intubation (ETI) during residency training. Difficulties in performing neonatal ETI lie in particularities of the neonates airway anatomy. The videolaryngoscope (VL) technique has been well incorporated to the adult and pediatric medical fields. Video assisted intubation could be a method of choice in teaching neonatal ETI. Only preliminary experience has been described. Objectives: 1) In the learning phase, primary outcome was to assess ETI success rate and secondary outcomes were to assess time to successful ETI and rate of esophageal intubation, comparing the VL to the classic laryngoscope (CL) technique; 2) In the evaluation phase, the objective was to assess if the ETI competence acquired from the VL was transferable to the CL by comparing the same outcomes. Methods Between June and October 2012, we held a randomized controlled trial at CHU Sainte-Justine’s Mother and Child Simulation Center. Third and fourth year medical students training at the Université de Montréal and going through their pediatrics rotation were asked to participate. Subjects were randomized into group A which used VL for the learning phase and CL for the evaluation phase and group B which used CL for both phases. Each subject performed 9 ETI on 3 different simulated neonatal airways in each phase. This study was approved by local IRB. Results Thirty four (16 in group A and 18 in group B) students performed 612 intubations; 28/34 (81%) of students were in third year. None had performed neonatal ETI before the study. Results are presented in Table 1. Success in group A did not change significantly when tested during phase 2 on the CL (NS). Group B continued to improve and had better success during phase 2 (p<0.001). Time to successful intubation improved significantly in group A from phase 1 to phase 2 (p<0.001) but not in group B (NS).Conclusion Success rate of ETI is improved and esophageal intubation decreased while learning ETI using the VL compared to the CL. Although time to successful intubation is longer using the VL, the time difference is not clinically significant. Once ETI is mastered on manikins using the VL, this competence is easily transferred to the use of the CL. Disclosures None.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.014 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".