Simulation technique for difficult intubation: teaching tool or new hazard?


Journal Article (Review)

This investigation evaluated the risks of a simulation drill designed to improve the skill of anesthesia personnel in dealing with an unexpected difficult intubation. In a controlled prospective study, 40 patients with normal airways scheduled to undergo noncardiothoracic surgery were randomized into two groups of 20 patients. In the control group, intubation was performed by standard techniques. In the simulation group, intubation of a difficult airway was simulated and performed with the aid of an endotracheal tube introducer. Heart rate (HR); systolic, mean, and diastolic blood pressures (BPs); and arterial oxygen saturation were measured noninvasively during the preinduction period and 1 minute postintubation. A record was kept of all adverse events, including electrocardiogram (EKG) evidence of myocardial ischemia or cardiac arrhythmias, esophageal intubation, pulmonary aspiration, or tracheal injury. There were no significant differences in percent changes in HR, BP, or oxygen saturation between the two groups. There were five uncomplicated esophageal intubations in the simulation group compared with none in the control group (p = 0.001). No other adverse events were recorded. The potential hazards of esophageal intubation should be considered before this simulation drill is performed.

Full Text

Duke Authors

Cited Authors

  • Goldberg, JS; Bernard, AC; Marks, RJ; Sladen, RN

Published Date

  • January 1990

Published In

Volume / Issue

  • 2 / 1

Start / End Page

  • 21 - 26

PubMed ID

  • 2178643

Pubmed Central ID

  • 2178643

International Standard Serial Number (ISSN)

  • 0952-8180

Digital Object Identifier (DOI)

  • 10.1016/0952-8180(90)90044-4


  • eng

Conference Location

  • United States