Apprentissage sur mannequin de l'intubation tracheale a l'aide d'un videolaryngoscope (Glidescope®)

Abstract

L'objectif de notre etude est d'evaluer l'apprentissage du Glidescope® par les infirmiers anesthesistes du CHUSS. L'Etude prospective a ete realisee au CHUSS de Bobo-Dioulasso. 30 operateurs ayant une experience variable en anesthesie ont realise chacun 10 tentatives d'intubation orotracheale avec le Glidescope® sur un mannequin d'intubation standard adulte. Le critere de jugement principal etait le delai necessaire pour realiser !'intubation tracheale. Les criteres de jugement  secondaires incluaient: la duree d'exposition, la duree entre I' exposition glottique et !'intubation et le taux d'echec d'intubation. La decroissance de la duree d'intubation entre le premier et le demier essai etait significative. Cette  decroissance n'etait pas continue, et i1 existait un plateau a partir du sixieme essai. Le taux global d'echec toutes tentatives confondues etait de 7,7 %. A partir de la troisieme tentative i1 n'y avait aucun echec. Tous les echecs sont survenus apres 1' exposition et etaient de 2 types : intubation resophagienne, ou echec d'insertion du tube dans le temps imparti (120 secondes). La vitesse  d'apprentissage n'etait pas liee a 1' experience. L'utilisation du Glidescope® necessite un  apprentissage. Cet apprentissage qui semble etre rapide ainsi que les taux de succes eleves qu'il procure quelle que soit I' experience anterieure de l'operateur peuvent plaider en faveur de son utilisation dans notre contexte ou la majeure partie des intubations sont faites par les infirmiers anesthesistes.

Mots-cles : Glidescope®, apprentissage, infirmiers anesthesistes, Bobo-Dioulasso.

Our work consist to evaluate the learning of GlideScope® by nurse anesthetists of CHUSS. Prospective single-center study has been conducted in CHUSS. 30  operators with varying experience in anesthesia have made each 10 attempts of oro tracheal intubation with GlideS cope® on a mannequin of standard adult intubation. The primary endpoint was the time required to perform tracheal intubation. The secondary endpoints included: the length of exposure, the time between exposure and the glottal intubation and the rate of intubation failure. There was a significant decrease in the duration of intubation between the first and last test, indicating a learning by different operators. However, this decrease is not continuous, and there is a plate from the sixth test. The overall failure rate across all attempts was 7.7%. We did not find a failure from the third attempt. All failures occurred after exposure and were 2 types: esophageal intubation, or the insertion of the tube failure in the time (120 seconds). It is not noted impact of the experience on the learning speed. The GlideScope® need learning. This learning is fast and the high rate of success that provides whatever the previous experience of the operator can advocate the use of  GlideScope® in our context or most intubations are made by nurse  anesthetists

Keywords: GlideScope®, learning, nurse anesthetists, Bobo-Dioulasso.