Insertion of the endotracheal tube, laryngeal mask airway and oesophageal-tracheal Combitube®. A 6-month comparative prospective study of acquisition and retention skills by medical students

Objective: To assess the ability of medical students to learn and retain skills of airway manipulation for insertion of the endotracheal tube, the laryngeal mask airway (Laryngeal Mask Company, Henley-on-Thames, UK) and the oesophageal-tracheal Combitube® (Kendall-Sheridan Catheter Corp., Argyle, NY, USA). Methods: A 6-month prospective study was conducted among fifth-year medical students attending a 3-week clerkship in the Division of Anesthesiology and Critical Care Medicine in the Soroka Medical Center. All the students viewed a demonstration of insertion technique for the endotracheal tube, the laryngeal mask airway and the Combitube®, followed by formal teaching in a mannikin. At the end of the program, the insertion skills were demonstrated in the mannikin, the success rate on the first attempt was registered and the students were requested to assess (by questionnaire) their ability to execute airway manipulation (phase 1). Six months later, the students were requested to repeat the insertion technique, and a similar re-evaluation applied (phase 2). Results: The success rate, during the first phase, at first attempts was 100% for the laryngeal mask airway and the Combitube®, compared to 57.4% for the endotracheal tube (P < 0.02), and 92.6%, 96.2% and 62.9% (P < 0.02) respectively for the second phase of the study. Conclusion: Learning and retention skills of medical students, in a mannikin, are more accentuated with the laryngeal mask airway and the Combitube® than seen with an endotracheal tube.