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Title of the item:

Improving detection by pediatric residents of endotracheal tube dislodgement with capnography: a randomized controlled trial.

Title:
Improving detection by pediatric residents of endotracheal tube dislodgement with capnography: a randomized controlled trial.
Authors:
Langhan ML; Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA. />Auerbach M
Smith AN
Chen L
Source:
The Journal of pediatrics [J Pediatr] 2012 Jun; Vol. 160 (6), pp. 1009-14.e1. Date of Electronic Publication: 2012 Jan 11.
Publication Type:
Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
Language:
English
Imprint Name(s):
Original Publication: St. Louis, MO : Mosby
MeSH Terms:
Clinical Competence*
Intubation, Intratracheal*
Trachea*
Capnography/*methods
Foreign-Body Migration/*diagnosis
Internship and Residency/*standards
Child ; Humans ; Oximetry ; Patient Simulation ; Reproducibility of Results
Entry Date(s):
Date Created: 20120117 Date Completed: 20120731 Latest Revision: 20120525
Update Code:
20240104
DOI:
10.1016/j.jpeds.2011.12.012
PMID:
22244462
Academic Journal
Objective: The authors sought to determine if capnography could improve time to correction of a simulated endotracheal tube (ETT) dislodgement by pediatric residents.
Study Design: Pediatric residents attended a didactic session that included interpretation of capnography. A randomized controlled study was then performed using patient simulators. Residents were randomized to standard monitoring (control group) or standard monitoring plus capnography (intervention group). The primary outcome was time to correction of ETT dislodgement. Correction of dislodgement prior to decline in pulse oximetry was our secondary outcome.
Results: Twenty-seven subjects completed the simulation. Subjects in the intervention group corrected the ETT dislodgement faster than those in the control group (2.38 minutes vs 3.92 minutes, P = .02). There were no differences in time to correction based on postgraduate year, clinical experiences, or comfort with capnography. Two subjects corrected the dislodgement prior to changes in pulse oximetry, both from the intervention group. Fifty-nine percent of subjects had seen capnography used in the past and 82% felt very or somewhat comfortable with capnography.
Conclusion: Capnography decreased time to correction of ETT dislodgement by pediatric residents. Capnography should be considered as an essential monitoring device for intubated patients to enhance patient safety.
(Copyright © 2012 Mosby, Inc. All rights reserved.)

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