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Related Concept Videos

Endotracheal Intubation I: Procedure01:15

Endotracheal Intubation I: Procedure

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Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
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Endotracheal Intubation II: Nursing Management01:17

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Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
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Endotracheal Tube Extubation01:24

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Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
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Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques01:30

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Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
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Tracheostomy Care I: Pre-procedural Steps01:16

Tracheostomy Care I: Pre-procedural Steps

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A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:
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Tracheostomy Suctioning I: Pre-Procedural Steps01:26

Tracheostomy Suctioning I: Pre-Procedural Steps

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Tracheostomy suctioning is a critical procedure healthcare professionals perform to maintain a patent airway in patients with a tracheostomy tube. This procedure is necessary when secretions accumulate in the airway, causing respiratory distress. Here is a step-wise procedural guide for performing tracheostomy suctioning using an open system.
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Related Experiment Video

Updated: Sep 17, 2025

Endotracheal Intubation Using a Flexible Intubation Endoscope as a Standardized Model for Safe Airway Management in Swine
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Effect of a Training Program for Nonanesthesiologists on Out-of-Operating Room Endotracheal Intubation.

Jesse Tucker1,2, Juan Ferre-Martinez1, Angel Chen3

  • 1Division of Pulmonary, Allergy, and Critical Care.

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Summary

A standardized training program for out-of-operating room airway management (OOORAM) improved first-pass laryngoscopy success rates. This training also significantly reduced esophageal intubations, enhancing patient safety outside the OR.

Keywords:
airway managementcritical careprocedural training

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Area of Science:

  • Emergency Medicine
  • Anesthesiology
  • Medical Education

Background:

  • Out-of-operating room airway management (OOORAM) presents unique challenges and higher complication rates compared to in-OR procedures.
  • Variability in healthcare systems' approaches to OOORAM, operator training, and expertise can lead to adverse patient outcomes.
  • The Veterans Health Administration implemented a mandatory, standardized OOORAM training program in 2013 to address these issues.

Purpose of the Study:

  • To evaluate the impact of the standardized OOORAM training program on first-pass laryngoscopy success.
  • To assess changes in endotracheal intubation success rates and esophageal intubation events post-training.
  • To analyze the effect of OOORAM training on experienced providers specifically.

Main Methods:

  • Retrospective cross-sectional study analyzing out-of-operating room endotracheal intubations from June 2008 to June 2018.
  • Data extracted from electronic medical records, comparing the 5 years before and after the 2013 OOORAM program implementation.
  • Primary outcome: first-pass laryngoscopy success; secondary analysis focused on experienced providers.

Main Results:

  • Overall first-pass laryngoscopy success improved significantly from 73.0% to 78.2% post-training (OR, 1.36).
  • The rate of esophageal intubation decreased significantly from 9.6% to 5.1% (P=.001).
  • No significant improvement in first-pass success was observed in the experienced provider cohort; video laryngoscopy use showed no significant difference.

Conclusions:

  • A facility-wide, standardized OOORAM training intervention is associated with improved first-pass laryngoscopy success.
  • The training program effectively reduced esophageal intubation rates, enhancing patient safety.
  • Further research may be needed to optimize training for experienced providers.