Digital intubation training in residency program as an alternative method in airway management

Abstract

Objectives: Digital intubation is a method for airway management in patients with distorted anatomy and cervical or skull fractures wherein movement is undesirable. This study was designed to determine whether digital intubation training is effective for airway control by emergency medicine or anesthesiology residents. Methodology: A prospective descriptive study of clinical education was carried out in the Nikoukari Hospital. In this study 15 anesthesiology and 15 emergency medicine residents received digital intubation training. Then they were asked to intubate patients with grade I or II Mallampati class, with no more than two attempts. Digital intubation was attempted after induction of anesthesia. Tube placement was confirmed by direct laryngoscopy. The total time for all attempts was recorded. Results: In 18 of 30 trainees, intubation was successful in first attempt (60%). The success rate was 80% for all attempts. The average time required for digital intubation (either success or failure) was 22 seconds. A 100% success rate was observed in trainees with long fingers. Any trauma induced bleeding in oral cavity was not reported. Conclusions: Although the gold standard for endotracheal intubation is direct laryngoscopy, digital intubation training might be considered as an easy and life-saving adjunction for airway management.