J Dent Anesth Pain Med.  2015 Dec;15(4):207-212.

Endotracheal intubation by inexperienced trainees using the Clarus Video System: learning curve and orodental trauma perspectives

• Moon YJ
• Kim J
• Seo DW
• Kim JW
• Jung HW
• Suk EH
• Ha SI
• Kim SH
• Kim JU

Abstract

BACKGROUND
The ideal alternative airway device should be intuitive to use, yielding proficiency after only a few trials. The Clarus Video System (CVS) is a novel optical stylet with a semi-rigid tip; however, the learning curve and associated orodental trauma are poorly understood.
METHODS
Two novice practitioners with no CVS experience performed 30 intubations each. Each trial was divided into learning (first 10 intubations) and standard phases (remaining 20 intubations). Total time to achieve successful intubation, number of intubation attempts, ease of use, and orodental trauma were recorded.
RESULTS
Intubation was successful in all patients. In 51 patients (85%), intubation was accomplished in the first attempt. Nine patients required two or three intubation attempts; six were with the first 10 patients. Learning and standard phases differed significantly in terms of success at first attempt, number of attempts, and intubation time (70% vs. 93%, 1.4 ± 0.7 vs. 1.1 ± 0.3, and 71.4 ± 92.3 s vs. 24.6 ± 21.9 s, respectively). The first five patients required longer intubation times than the subsequent five patients (106.8 ± 120.3 s vs. 36.0 ± 26.8 s); however, the number of attempts was similar. Sequential subgroups of five patients in the standard phase did not differ in the number of attempts or intubation time. Dental trauma, lip laceration, or mucosal bleeding were absent.
CONCLUSIONS
Ten intubations are sufficient to learn CVS utilization properly without causing any orodental trauma. A relatively small number of experiences are required in the learning curve compared with other devices.

Keyword

Education; Intubation; Learning curve; Orodental trauma

MeSH Terms

Education
Hemorrhage
Humans
Intubation
Intubation, Intratracheal*
Lacerations
Learning Curve*
Learning*
Lip

Figure

• 

  Fig. 1 Intubation times and number of attempts using Clarus Video System by two novice practitioners (A and B). *Two attempts required to intubate, †Intubation failed within two attempts

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