ADOPTION OF VIDEO LARYNGOSCOPY IN MASSACHUSETTS EMERGENCY DEPARTMENTS

作者:Raja Ali S*; Sullivan Ashley F; Pallin Daniel J; Bohan J Stephen; Camargo Carlos A Jr
来源:Journal of Emergency Medicine, 2012, 42(2): 233-237.
DOI:10.1016/j.jemermed.2010.10.020

摘要

Background: Previous research suggests that video laryngoscopy may be superior to direct laryngoscopy. Objectives: We sought to determine the proportion of Massachusetts emergency departments (EDs) that have adopted video laryngoscopy, the characteristics of user and non-user EDs, the reasons why non-users do not use video laryngoscopy, and how the adoption of video laryngoscopy compares to typical technology adoption life cycles. Methods: Surveys were mailed to directors of all non-federal EDs in Massachusetts (n = 74) in early 2009. Non-responders received repeat mailings and were then contacted via telephone or e-mail. Results: Sixty-three of 74 (85%) EDs responded and 43% had adopted video laryngoscopy. EDs with video laryngoscopy had a higher median annual visit volume than EDs without video laryngoscopy (48,000 vs. 36,500, p = 0.04), but had similar mean intubations per week (4.5 vs. 4.4, p = 0.97) and mean surgical airways per year (0.7 vs. 1.1, p = 0.19). Half of the EDs affiliated with emergency medicine residency programs had video laryngoscopy available. Among EDs with video laryngoscopy, the technology had been available for >5 years in 4% (1/27), 1-5 years in 44% (12/27), and <1 year in 52% (14/27). Although EDs not using video laryngoscopy did not do so primarily because it was too expensive (69% [25/361), video laryngoscopy adoption has still progressed more rapidly than predicted by the typical technology adoption timeline. Conclusion: Video laryngoscopy has been adopted by 43% of Massachusetts EDs; results were similar in academic institutions. Cost is the primary barrier to adoption for non-user EDs, but adoption is progressing more rapidly than expected for a new technology.

  • 出版日期2012-2