期刊
SIMULATION IN HEALTHCARE-JOURNAL OF THE SOCIETY FOR SIMULATION IN HEALTHCARE
卷 15, 期 3, 页码 160-166出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/SIH.0000000000000426
关键词
Intubation; kinematics; machine learning
资金
- American Heart Association, Dallas, Texas [118243]
- American Heart Association
Background Endotracheal intubation (ETI) is an important emergency intervention. Only limited data describe ETI skill acquisition and often use bulky technology, not easily transitioned to the clinical setting. In this study, we used small, portable inertial detection technology to characterize intubation kinematic differences between experienced and novice intubators. Methods We performed a prospective study including novice (<10 prior clinical ETI) and experienced (>100 clinical ETI) emergency providers. We tracked upper extremity motion with roll, pitch, and yaw using inertial measurement units (IMU) placed on the bilateral hands and wrists of the intubator. Subject performed 6 simulated emergency intubations on a mannequin. Using machine learning algorithms, we determined the motions that best discriminated experienced and novice providers. Results We included data on 12 novice and 5 experienced providers. Four machine learning algorithms (artificial neural network, support vector machine, decision tree, and K-nearest neighbor search) were applied. Artificial neural network had the greatest accuracy (95% confidence interval) for discriminating between novice and experienced providers (91.17%, 90.8%-91.5%) and was the most parsimonious of the tested algorithms. Using artificial neural network, information from 5 movement features (right hand, roll amplitude; right hand, pitch amplitude; right hand, yaw standard deviation; left hand, yaw standard deviation; left hand, pitch frequency of peak amplitude) was able discriminated experienced from novice providers. Conclusions Novice and experienced providers have different ETI movement patterns and can be distinguished by 5 specific movements. Inertial detection technology can be used to characterize the kinematics of emergency airway management.
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