Downward trend in pediatric resident laryngoscopy participation in PICUs

National Emergency Airway Registry for Children (NEAR4KIDS), Pediatric Acute Lung Injury and Sepsis Investigators (PALISI)

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objectives: As of July 2013, pediatric resident trainee guidelines in the United States no longer require proficiency in nonneonatal tracheal intubation. We hypothesized that laryngoscopy by pediatric residents has decreased over time, with a more pronounced decrease after this guideline change. Design: Prospective cohort study. Setting: Twenty-five PICUs at various children's hospitals across the United States. Patients: Tracheal intubations performed in PICUs from July 2010 to June 2016 in the multicenter tracheal intubation database (National Emergency Airway Registry for Children). Intervention: None. Measurements and Main Results: Prospective cohort study in which all primary tracheal intubations occurring in the United States from July 2010 to June 2016 in the multicenter tracheal intubation database (National Emergency Airway Registry for Children) were analyzed. Participating PICU leaders were also asked to describe their local airway management training for residents. Resident participation trends over time, stratified by presence of a Pediatric Critical Care Medicine fellowship and airway training curriculum for residents, were described. A total of 9,203 tracheal intubations from 25 PICUs were reported. Pediatric residents participated in 16% of tracheal intubations as first laryngoscopists: 14% in PICUs with a Pediatric Critical Care Medicine fellowship and 34% in PICUs without one (p < 0.001). Resident participation decreased significantly over time (3.4% per year; p < 0.001). The decrease was significant in ICUs with a Pediatric Critical Care Medicine fellowship (p < 0.001) but not in ICUs without one (p = 0.73). After adjusting for site-level clustering, patient characteristics, and Pediatric Critical Care Medicine fellowship presence, the Accreditation Council for Graduate Medical Education guideline change was not associated with lower participation by residents (odds ratio, 0.86; 95% CI, 0.59-1.24; p = 0.43). The downward trend of resident participation was similar regardless of the presence of an airway curriculum for residents. Conclusion: Laryngoscopy by pediatric residents has substantially decreased over time. This downward trend was not associated with the 2013 Accreditation Council for Graduate Medical Education change in residency requirements.

Original languageEnglish (US)
Pages (from-to)E242-E250
JournalPediatric Critical Care Medicine
Volume19
Issue number5
DOIs
StatePublished - May 1 2018

Fingerprint

Laryngoscopy
Intubation
Pediatrics
Critical Care
Medicine
Graduate Medical Education
Accreditation
Guidelines
Curriculum
Registries
Emergencies
Cohort Studies
Databases
Prospective Studies
Airway Management
Internship and Residency
Cluster Analysis
Odds Ratio

Keywords

  • Accreditation Council for Graduate Medical Education
  • Pediatric intensive care unit
  • Resident
  • Tracheal intubation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

Cite this

National Emergency Airway Registry for Children (NEAR4KIDS), & Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) (2018). Downward trend in pediatric resident laryngoscopy participation in PICUs. Pediatric Critical Care Medicine, 19(5), E242-E250. https://doi.org/10.1097/PCC.0000000000001470

Downward trend in pediatric resident laryngoscopy participation in PICUs. / National Emergency Airway Registry for Children (NEAR4KIDS); Pediatric Acute Lung Injury and Sepsis Investigators (PALISI).

In: Pediatric Critical Care Medicine, Vol. 19, No. 5, 01.05.2018, p. E242-E250.

Research output: Contribution to journalArticle

National Emergency Airway Registry for Children (NEAR4KIDS) & Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) 2018, 'Downward trend in pediatric resident laryngoscopy participation in PICUs', Pediatric Critical Care Medicine, vol. 19, no. 5, pp. E242-E250. https://doi.org/10.1097/PCC.0000000000001470
National Emergency Airway Registry for Children (NEAR4KIDS), Pediatric Acute Lung Injury and Sepsis Investigators (PALISI). Downward trend in pediatric resident laryngoscopy participation in PICUs. Pediatric Critical Care Medicine. 2018 May 1;19(5):E242-E250. https://doi.org/10.1097/PCC.0000000000001470
National Emergency Airway Registry for Children (NEAR4KIDS) ; Pediatric Acute Lung Injury and Sepsis Investigators (PALISI). / Downward trend in pediatric resident laryngoscopy participation in PICUs. In: Pediatric Critical Care Medicine. 2018 ; Vol. 19, No. 5. pp. E242-E250.
@article{aac97a09f64d47a3bc340a095d9e946f,
title = "Downward trend in pediatric resident laryngoscopy participation in PICUs",
abstract = "Objectives: As of July 2013, pediatric resident trainee guidelines in the United States no longer require proficiency in nonneonatal tracheal intubation. We hypothesized that laryngoscopy by pediatric residents has decreased over time, with a more pronounced decrease after this guideline change. Design: Prospective cohort study. Setting: Twenty-five PICUs at various children's hospitals across the United States. Patients: Tracheal intubations performed in PICUs from July 2010 to June 2016 in the multicenter tracheal intubation database (National Emergency Airway Registry for Children). Intervention: None. Measurements and Main Results: Prospective cohort study in which all primary tracheal intubations occurring in the United States from July 2010 to June 2016 in the multicenter tracheal intubation database (National Emergency Airway Registry for Children) were analyzed. Participating PICU leaders were also asked to describe their local airway management training for residents. Resident participation trends over time, stratified by presence of a Pediatric Critical Care Medicine fellowship and airway training curriculum for residents, were described. A total of 9,203 tracheal intubations from 25 PICUs were reported. Pediatric residents participated in 16{\%} of tracheal intubations as first laryngoscopists: 14{\%} in PICUs with a Pediatric Critical Care Medicine fellowship and 34{\%} in PICUs without one (p < 0.001). Resident participation decreased significantly over time (3.4{\%} per year; p < 0.001). The decrease was significant in ICUs with a Pediatric Critical Care Medicine fellowship (p < 0.001) but not in ICUs without one (p = 0.73). After adjusting for site-level clustering, patient characteristics, and Pediatric Critical Care Medicine fellowship presence, the Accreditation Council for Graduate Medical Education guideline change was not associated with lower participation by residents (odds ratio, 0.86; 95{\%} CI, 0.59-1.24; p = 0.43). The downward trend of resident participation was similar regardless of the presence of an airway curriculum for residents. Conclusion: Laryngoscopy by pediatric residents has substantially decreased over time. This downward trend was not associated with the 2013 Accreditation Council for Graduate Medical Education change in residency requirements.",
keywords = "Accreditation Council for Graduate Medical Education, Pediatric intensive care unit, Resident, Tracheal intubation",
author = "{National Emergency Airway Registry for Children (NEAR4KIDS)} and {Pediatric Acute Lung Injury and Sepsis Investigators (PALISI)} and Aayush Gabrani and Taiki Kojima and Sanders, {Ronald C.} and Asha Shenoi and Vicki Montgomery and Parsons, {Simon J.} and Sandeep Gangadharan and Sholeen Nett and Natalie Napolitano and Keiko Tarquinio and Simon, {Dennis W.} and Anthony Lee and Guillaume Emeriaud and Michelle Adu-Darko and Giuliano, {John S.} and Keith Meyer and Graciano, {Ana Lia} and Turner, {David A.} and Conrad Krawiec and Bakar, {Adnan M.} and Polikoff, {Lee A.} and Margaret Parker and Ilana Harwayne-Gidansky and Benjamin Crulli and Paula Vanderford and Breuer, {Ryan K.} and Eleanor Gradidge and Aline Branca and Grater-Welt, {Lily B.} and David Tellez and Wright, {Lisa V.} and Matthew Pinto and Vinay Nadkarni and Akira Nishisaki",
year = "2018",
month = "5",
day = "1",
doi = "10.1097/PCC.0000000000001470",
language = "English (US)",
volume = "19",
pages = "E242--E250",
journal = "Pediatric Critical Care Medicine",
issn = "1529-7535",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Downward trend in pediatric resident laryngoscopy participation in PICUs

AU - National Emergency Airway Registry for Children (NEAR4KIDS)

AU - Pediatric Acute Lung Injury and Sepsis Investigators (PALISI)

AU - Gabrani, Aayush

AU - Kojima, Taiki

AU - Sanders, Ronald C.

AU - Shenoi, Asha

AU - Montgomery, Vicki

AU - Parsons, Simon J.

AU - Gangadharan, Sandeep

AU - Nett, Sholeen

AU - Napolitano, Natalie

AU - Tarquinio, Keiko

AU - Simon, Dennis W.

AU - Lee, Anthony

AU - Emeriaud, Guillaume

AU - Adu-Darko, Michelle

AU - Giuliano, John S.

AU - Meyer, Keith

AU - Graciano, Ana Lia

AU - Turner, David A.

AU - Krawiec, Conrad

AU - Bakar, Adnan M.

AU - Polikoff, Lee A.

AU - Parker, Margaret

AU - Harwayne-Gidansky, Ilana

AU - Crulli, Benjamin

AU - Vanderford, Paula

AU - Breuer, Ryan K.

AU - Gradidge, Eleanor

AU - Branca, Aline

AU - Grater-Welt, Lily B.

AU - Tellez, David

AU - Wright, Lisa V.

AU - Pinto, Matthew

AU - Nadkarni, Vinay

AU - Nishisaki, Akira

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Objectives: As of July 2013, pediatric resident trainee guidelines in the United States no longer require proficiency in nonneonatal tracheal intubation. We hypothesized that laryngoscopy by pediatric residents has decreased over time, with a more pronounced decrease after this guideline change. Design: Prospective cohort study. Setting: Twenty-five PICUs at various children's hospitals across the United States. Patients: Tracheal intubations performed in PICUs from July 2010 to June 2016 in the multicenter tracheal intubation database (National Emergency Airway Registry for Children). Intervention: None. Measurements and Main Results: Prospective cohort study in which all primary tracheal intubations occurring in the United States from July 2010 to June 2016 in the multicenter tracheal intubation database (National Emergency Airway Registry for Children) were analyzed. Participating PICU leaders were also asked to describe their local airway management training for residents. Resident participation trends over time, stratified by presence of a Pediatric Critical Care Medicine fellowship and airway training curriculum for residents, were described. A total of 9,203 tracheal intubations from 25 PICUs were reported. Pediatric residents participated in 16% of tracheal intubations as first laryngoscopists: 14% in PICUs with a Pediatric Critical Care Medicine fellowship and 34% in PICUs without one (p < 0.001). Resident participation decreased significantly over time (3.4% per year; p < 0.001). The decrease was significant in ICUs with a Pediatric Critical Care Medicine fellowship (p < 0.001) but not in ICUs without one (p = 0.73). After adjusting for site-level clustering, patient characteristics, and Pediatric Critical Care Medicine fellowship presence, the Accreditation Council for Graduate Medical Education guideline change was not associated with lower participation by residents (odds ratio, 0.86; 95% CI, 0.59-1.24; p = 0.43). The downward trend of resident participation was similar regardless of the presence of an airway curriculum for residents. Conclusion: Laryngoscopy by pediatric residents has substantially decreased over time. This downward trend was not associated with the 2013 Accreditation Council for Graduate Medical Education change in residency requirements.

AB - Objectives: As of July 2013, pediatric resident trainee guidelines in the United States no longer require proficiency in nonneonatal tracheal intubation. We hypothesized that laryngoscopy by pediatric residents has decreased over time, with a more pronounced decrease after this guideline change. Design: Prospective cohort study. Setting: Twenty-five PICUs at various children's hospitals across the United States. Patients: Tracheal intubations performed in PICUs from July 2010 to June 2016 in the multicenter tracheal intubation database (National Emergency Airway Registry for Children). Intervention: None. Measurements and Main Results: Prospective cohort study in which all primary tracheal intubations occurring in the United States from July 2010 to June 2016 in the multicenter tracheal intubation database (National Emergency Airway Registry for Children) were analyzed. Participating PICU leaders were also asked to describe their local airway management training for residents. Resident participation trends over time, stratified by presence of a Pediatric Critical Care Medicine fellowship and airway training curriculum for residents, were described. A total of 9,203 tracheal intubations from 25 PICUs were reported. Pediatric residents participated in 16% of tracheal intubations as first laryngoscopists: 14% in PICUs with a Pediatric Critical Care Medicine fellowship and 34% in PICUs without one (p < 0.001). Resident participation decreased significantly over time (3.4% per year; p < 0.001). The decrease was significant in ICUs with a Pediatric Critical Care Medicine fellowship (p < 0.001) but not in ICUs without one (p = 0.73). After adjusting for site-level clustering, patient characteristics, and Pediatric Critical Care Medicine fellowship presence, the Accreditation Council for Graduate Medical Education guideline change was not associated with lower participation by residents (odds ratio, 0.86; 95% CI, 0.59-1.24; p = 0.43). The downward trend of resident participation was similar regardless of the presence of an airway curriculum for residents. Conclusion: Laryngoscopy by pediatric residents has substantially decreased over time. This downward trend was not associated with the 2013 Accreditation Council for Graduate Medical Education change in residency requirements.

KW - Accreditation Council for Graduate Medical Education

KW - Pediatric intensive care unit

KW - Resident

KW - Tracheal intubation

UR - http://www.scopus.com/inward/record.url?scp=85058704982&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85058704982&partnerID=8YFLogxK

U2 - 10.1097/PCC.0000000000001470

DO - 10.1097/PCC.0000000000001470

M3 - Article

C2 - 29406378

AN - SCOPUS:85058704982

VL - 19

SP - E242-E250

JO - Pediatric Critical Care Medicine

JF - Pediatric Critical Care Medicine

SN - 1529-7535

IS - 5

ER -