Novice and expert muscle utilization and wrist postures during simulated endotrachial intubation - A pilot study

Adam De Laveaga, Michael C. Wadman, Laura Wirth, M. Susan Hallbeck

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Endotracheal Intubation (ETI) is an airway procedure commonly used to secure the airway for a variety of medical conditions. Endotracheal tube placement is most commonly performed under direct vision of the glottis with the use of a standard laryngoscope and blade. Proficiency in ETI procedures requires significant clinical experience and insufficient data currently exists describing the physical ergonomics of successful direct laryngoscopy. The research objectives of this study were to examine how ETI time, error and practitioner biomechanics varied among clinical experience levels and hospital bed heights. The participant population included novice and expert subgroups recruited from the University of Nebraska Medical Center, and the department of Emergency Medicine. Using a standard laryngoscope handle and blade, participants performed ETI trials on an airway manikin trainer at a minimum and maximum bed height. Participants were evaluated based on ETI completion time, endotracheal tube placement, wrist postures and technique errors. Task completion time and ETI errors did not vary with hospital bed height. Muscle utilization did not differ significantly between bed heights or expert and novice participants. Experts exhibited greater wrist extension and less ulnar deviation during task trials. Expert participants grasped the laryngoscope differently than novice participants, resulting in less wrist manipulation required to achieve ideal instrument positions. By encouraging ideal hand and arm postures during ETI training and simulation, the opportunity exists to improve patient safety and reduce the significant learning curve associated with ETI procedures.

Original languageEnglish (US)
Title of host publicationProceedings of the Human Factors and Ergonomics Society 55th Annual Meeting, HFES 2011
Pages705-709
Number of pages5
DOIs
StatePublished - Nov 28 2011
Event55th Human Factors and Ergonomics Society Annual Meeting, HFES 2011 - Las Vegas, NV, United States
Duration: Sep 19 2011Sep 23 2011

Publication series

NameProceedings of the Human Factors and Ergonomics Society
ISSN (Print)1071-1813

Other

Other55th Human Factors and Ergonomics Society Annual Meeting, HFES 2011
CountryUnited States
CityLas Vegas, NV
Period9/19/119/23/11

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ASJC Scopus subject areas

  • Human Factors and Ergonomics

Cite this

De Laveaga, A., Wadman, M. C., Wirth, L., & Hallbeck, M. S. (2011). Novice and expert muscle utilization and wrist postures during simulated endotrachial intubation - A pilot study. In Proceedings of the Human Factors and Ergonomics Society 55th Annual Meeting, HFES 2011 (pp. 705-709). (Proceedings of the Human Factors and Ergonomics Society). https://doi.org/10.1177/1071181311551146