Respiratory Therapist Endotracheal Intubation Practices

Endotracheal intubation is a common procedure performed by respiratory therapists (RTs). The purpose of this study was to describe current RT intubation practices in North Carolina through the use of a survey instrument.

A survey was developed by the authors using REDCap. The survey was sent via email to all licensed RTs in North Carolina. Information collected included respondent demographics, intubation practices (including training and skill maintenance), and attitudes about RT intubation practices.

Of the 411 respondents, 68% intubated at their facility, representing 81 unique institutions. RTs who performed intubation were more likely to be from community hospitals and less likely to be from level 1 trauma centers. Respondents reported intubating adult (91%), pediatric (61%), and neonatal (65%) patients. The most common areas in which RTs reported performing intubation were the adult ICU (80%), emergency department (76%), outside the operating room for emergencies (76%), neonatal ICU (43%), the delivery room (45%), and pediatric ICU (25%). The median (interquartile range) number of supervised intubations required to be considered competent was 5 (3-5). The most common numbers of intubations required to be considered competent were 5 (32%), 3 (26%), 10 (16%), 2 (4%), and 0 (3%). The perceived number of intubations to achieve 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%) and effective (91%), and that RTs were well-trained (81%), that their intubation skills were objectively evaluated (66%), and that RTs receive sufficient feedback on performance (68%).

RTs in North Carolina frequently performed intubation and had high confidence in their programs. Further studies are needed to establish standardized training for endotracheal intubation, document success rates for intubations, and evaluate the use of video laryngoscopy by RTs.