A Tiny Baby Intubation Team Improves Endotracheal Intubation Success Rate but Decreases Residents’ Training Opportunities.

Abstract Objective: Assess the educational and clinical impact of a tiny baby intubation team (TBIT).Study Design: Retrospective study comparing endotracheal intubation (ETI) performed: pre-implementation of a TBIT (T1), six months post-implementation (T2), and four years post-implementation (T3).Results: Post-implementation of a TBIT, first attempt success rate in tiny babies increased (44% in T1 vs. 59% in T2; p=0.046) and the proportion of ETIs performed by residents decreased (53% in T1 vs. 37% in T2; p=0.002). After an educational quality improvement intervention (prioritizing non-tiny baby ETIs to residents, systematic simulation training and ETI using videolaryngoscopy), residents’ overall (63% in T2 vs. 79% in T3; p=0.03) and non-tiny baby ETI success rate improved (63% in T2 vs. 82% in T3; p=0.02).Conclusion: A TBIT improves success rate of ETIs in ELBW infants but decreases educational exposure of residents. Educational strategies helps maintain residents’ procedural exposure without impacting on quality of care.