The Reliability and Validity of a Simulated Airway Model that Quantifies Physical Forces Exerted During Endotracheal Intubation in a Clinically Demanding Scenario.

다국어 초록 (Multilingual Abstract)

The main purpose of this research was the development of an experimental model that allows for the assessment of pressure and thereby, the forces associated with interventions related to airway management. The foundation of this research was to develop, and assess the validity and reliability, of a method of quantifying the force experienced by a patient during airway management.
Following IRB approval and the development of a unique simulation model that employs transducers situated in key anatomical locations to determine forces, a multivariate profile analysis with covariate of experience using a MANCOVA approach was conducted. The statistical design consisted of 102 subjects testing the dependent measure of pressure for the following techniques: Fiberoptic intubation, the Fastrach(TM) LMA, the # 3 C-Mac video laryngoscope, and the TrachlightRTM. Independent variables analyzed were practitioner types: emergency medicine physicians, certified registered nurse anesthetists, and anesthesiologists, all tested over five locations: Chicago, Las Vegas, Atlanta, Seattle, and Boston, with a co-variable of experience.
Analysis demonstrated no difference in force attributed to the location, the airway provider or their interactions. This was contrasted by the finding that 81% of the variance in pressure scores was due to differences in airway techniques. The mannequin was also able to discern a subpopulation within techniques which lends to its validity. The mannequin preformed consistently regarding reproducible findings following the setup and dismantling over time and locations. This would seem to begin to form the bases of a valid and reliable tool for this and future research.