COMPARISON OF THREE DIFFERENT OT TABLE HEIGHT FOR INTUBATION IN TRAINEES-AN ERGONOMICS VIEW

Comparison of three different OT table height for intubation in trainees— an Ergonomics view

Background: Specific postures and practitioner ergonomics are not universally defined within intubation training. Setting OT table height at umbilical level of intubator, puts him in much discomfort and unsuccessful in intubation. The aim was to evaluate the effect of different OT table height on intubation time, success rate, and laryngeal view grading and posture discomfort. We decided to understand physical ergonomics of successful laryngoscopy posture and to improve trainees’ learning curve.

Methods: Seventy-five patients divided into three groups according to patient’s forehead at the level of intubator’s nipple line (group N), xiphisternum (group X) and umbilicus (group U). An observation for intubation time, success rate, discomfort in ventilation & intubation and posture was made.  From left sided photographs- neck & knee flexion angle, distance from intubator’s eye to heel of scope (cm) was noted.

Results: Putting patient forehead to intubator’s nipple level makes intubation less time consuming (p= 0.001) and with ergonomically erect posture and better laryngeal view. Distance from trainee’s eyes to heel of scope was more in group N (p value < 0.001). Trainees tended to bend towards patient’s mouth with bended posture in group U and group X than group N.

Conclusion:Higher OT table height can provide much better laryngeal view, keeps erect posture with less discomfort and less time-consuming intubation. Quality of laryngeal view as per Cormack Lehane grade was better in group N than at lower OT table heights. Discomfort score was higher in lower OT table height (32% and 16% patients in group U and X respectively) than at higher position

Key words: -Intubation, OT table height, Ergonomics, time-consuming