RT Journal Article
SR Electronic
T1 Respiratory Therapist Endotracheal Intubation Practices in North Carolina
JF Respiratory Care
FD American Association for Respiratory Care
SP 3225783
VO 64
IS Suppl 10
A1 Miller, Andrew G
A1 Gentile, Michael A
A1 Coyle, Joseph P
YR 2019
UL http://rc.rcjournal.com/content/64/Suppl_10/3225783.abstract
AB Background: Endotracheal intubation is a common procedure performed by respiratory therapists (RTs). The purpose of this study is to describe current RT intubation practices in North Carolina through the use of survey instrument. Methods: A survey was developed by the authors and sent via email to all licensed RTs in North Carolina. An exemption was granted by the Duke Institutional Review Board. Questions included: respondent demographics, intubation practices (including training and skill maintenance) and attitudes about RT intubation practices. Data are presented as percentages or medians with interquartile range (IQR). Results: The survey was sent to 4,817 licensed RTs, with 411 responses from 133 unique institutions and 81 (61%) intubated at their facility. RTs who performed intubation were more likely to be from community hospitals and less likely to be from level one trauma centers. 60% of respondents defined an intubation attempt as an endotracheal tube passed through the oropharynx with 34% defining an attempt as a laryngoscope in the mouth. Respondents reported intubating adults (91%), pediatric (61%), and (65%) neonatal patients. The most common areas RTs reported performing intubation were the adult ICU (80%), ED (76%), outside the OR for emergencies (76%), neonatal ICU (43%), the delivery room (45%), and pediatric ICU (25%). Training for intubation varied among respondents with classroom training (51%), written materials (38%), written test (27%), skill demonstration in a simulation setting (85%), and supervised intubations (71%) reported as training methods. Supervised intubations were performed in the operating room (54%), ICU (68%), ED (59%), delivery room (29%), and other (23%). 84% respondents reported there was no minimum amount of experience before intubation training. The reported number of supervised intubations required to be competent was 5 (3-5). Less than 10 intubations were required by 81% of respondents. The perceived number of intubations to gain competence was 6 (range 5-10) and did not differ based on years of experience. Most respondents believed their RT intubation program was safe (93%), effective (91%), RTs were well-trained (81%), their intubation skills objectively evaluated (66%), and receive sufficient feedback on performance (68%). Conclusions: RTs in North Carolina frequently provided intubation and had high confidence in their programs. Training methods and clinical practice varied throughout the state.