关键词: 床旁加强培训, 可视喉镜, 气管插管, 困难气道, 胜任力

Abstract: Objective To explore the role of bedside intensive video laryngoscope tracheal intubation training in emergency difficult airway intubation teaching. Methods Eighty-four rotating physicians in emergency resuscitation room were randomly divided into a simulation training group and a bedside intensive training group with 42 in each. They were asked to fill the questionnaire before and after the training, complete the simulated video laryngoscope tracheal intubation and the patient video laryngoscope tracheal intubation independently. The training satisfaction, intubation willingness, expected intubation success rate, counting number of intubation attempts, and intubation success rate, total time length of intubation, evaluation of difficult airway, evaluation after intubation, qualified rate of catheter position, qualified rate of balloon pressure, incidence of adverse reactions and other data were collected. Results There were no significant difference between age and educational background from the simulation training group and the bedside intensive training group. The scores of training satisfaction (98.0±1.08) of trainees in bedside intensive training were higher than those of the simulation training group (94.7±2.7) (P<0.01); The scores of willingness to try difficult intubation after training in the bedside intensive group (8.6±0.7) were higher than those of the simulation training group scored (6.62±1.34) (P<0.01); The expected intubation success rate in the bedside strengthening training group was 82.0%±5.6%, which was higher than that in the simulation training group 60.3%±11.3%(P<0.01). In the evaluation of the intubation process, compared with the simulation training group, the bedside intensive training group had fewer intubation attempts [1.0±0.4 vs. 2.0±0.7], and the intubation success rate was higher [39(92.9) vs. 28(66.7) ], the total intubation time was shorter [38.8±3.3 vs. 50.5±5.6](both P<0.01). In terms of post-intubation evaluation, compared with the simulation training group, the bedside intensive training group had a higher qualified rate of balloon pressure [41(97.6%) vs. 35 (83.3%)] and a higher qualified rate of catheter position [41(97.6%)] vs. 35(83.3%)], fewer adverse reactions of intubation: cough [1(2.1%) vs. 8(19.1%)], throat injury [0(0.0%) vs. 6(14.3%)](all P<0.05). Conclusions Bedside intensive laryngoscope tracheal intubation training can improve emergency physicians' confidence and skill in handling difficult airways.

Key words: bedside intensive training, video laryngoscopy, tracheal intubation, difficult airway, competency