Success rate of laryngeal mask insertion by medical students: Comparison between routine teaching method and four-stage teaching method

Introduction: Airway management is one of the priorities during cardiopulmonary resuscitation. Laryngeal mask (LM) served as an alternative airway management with high success rate. Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, performed regular teaching method as well as the four-stage teaching method. This study compared the results of teaching LM insertion for medical students between those who received four-stage teaching method and regular teaching in adult patients undergoing general anesthesia in Cipto Mangunkusumo Hospital. Methods: This was a randomized controlled trial of 43 students in the Department of Anesthesiology and Intensive Care. After the materials were given, every subject inserted LM in adult patients undergoing general anesthesia. The inclusion criteria were students who agreed to be research subjects, were willing to cooperate, followed research algorithm, had not received any training on LM insertion and had not done LM insertion to both mannequin and human. The success of the teaching was assessed by chest rising when ventilated, a number of attempts, and seal pressure. This research has been approved by the Ethics Committee of Faculty of Medicine University of Indonesia. Result: In both groups the study found 100% chest rising when ventilated. The group with four-stage teaching method required less number of attempts (p = 0.001) and generated higher seal pressure than the other group (25 cm H2O vs. 22 cm H2O, p = 0.018). Four-stage teaching method required less time for LM insertion (22 seconds vs. 50.5 seconds, p = 0.019). Conclusion: The result of the teaching LM insertion by medical students who get the four stage teaching method was better than the regular teaching method.