Alternating day emergency medicine and anesthesia resident responsibility for management of the XXXX airway: a study of laryngoscopy performance and intubation success.

@entity1 @entity341 @entity130
STUDY OBJECTIVE: We compare laryngoscopy performance and overall intubation success in @entity130 airways when primary airway management alternated between emergency medicine and anesthesia residents on an every-other-day basis. METHODS: Data on all @entity130 intubations during approximately 3 years were prospectively collected. Primary airway management was assigned to @entity341 ( @entity341 ) residents on even days and anesthesia residents on odd days. Emergency medicine residents intubated @entity1 who arrived without notification or who needed immediate intubation before anesthesia arrived. The study was conducted in an inner-city, Level I @entity130 center with approximately 50,000 @entity341 @entity1 and 1,800 major @entity130 cases a year. Main outcomes were success or failure at laryngoscopy and the number of laryngoscopy attempts needed for intubation. RESULTS: Six hundred fifty-eight @entity130 @entity1 were intubated during the study period. Laryngoscopy was successful in 654 of 656 cases. Two (0.3%) @entity1 underwent cricothyrotomy after failed laryngoscopy, and 2 (0.3%) @entity1 had awake nasal intubation without laryngoscopy. The specific number of laryngoscopy attempts was unknown in 6 cases (3 from each service), resulting in 650 cases for laryngoscopy performance analysis. Overall, 87% of @entity1 were intubated on first attempt, and 3 or more attempts occurred in 2.9% of @entity1 . Laryngoscopy performance by service (broken down by 1, 2, and >or=3 attempts) was as follows: emergency medicine 86.4%, 11%, and 2.6% versus anesthesia 89.7%, 6.7%, and 3.6%. Analysis by service was done by using Wilcoxon Mann-Whitney testing (P=.225). CONCLUSION: There were no differences in laryngoscopy performance and intubation success in @entity130 airways managed on an every-other-day basis by emergency medicine versus anesthesia residents.
