Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
European Archives of Oto-Rhino-Laryngology
Published in: European Archives of Oto-Rhino-Laryngology 12/2016

01-12-2016 | Miscellaneous

Self-directed simulation-based training of emergency cricothyroidotomy: a route to lifesaving skills

Authors: Jacob Melchiors, Tobias Todsen, Philip Nilsson, Andreas Pagh Kohl, Morten Bøttger, Birgitte Charabi, Lars Konge, Christian von Buchwald

Published in: European Archives of Oto-Rhino-Laryngology | Issue 12/2016

Login to get access

Abstract

The emergency cricothyroidotomy (EC) is a critical procedure. The high cost of failures increases the demand for evidence-based training methods. The aim of this study was to present and evaluate self-directed video-guided simulation training. Novice doctors were given an individual 1-h simulation training session. One month later, an EC on a cadaver was performed. All EC’s were video recorded. An assessment tool was used to rate performance. Performance was compared with a pass/fail level for the EC. We found a high reliability, based on Pearson’s r (0.88), and a significant progression of skill during training (p < 0.001). Eleven out of 14 succeeded in creating an airway on the cadaver in 64 s (median, range 39–86 s), but only four achieved a passing score. Our 1-h training protocol successfully raised the competence level of novice doctors; however, the training did not ensure that all participants attained proficiency.
Literature
1.
Henderson JJ, Popat MT, Latto IP, Pearce AC (2004) Difficult Airway Society guidelines for management of the unanticipated difficult intubation. Anaesthesia 59:675–694CrossRefPubMed
2.
Apfelbaum JL, Hagberg CA, Caplan RA et al (2013) Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology 118(2):251–270CrossRefPubMed
3.
Walls RM, Murphy MF (2012) Manual of emergency airway management, 4th edn. Lippincott Williams and Wilkins, Philadelphia, p 24
4.
Mock CN, Donkor P, Gawande A et al (2015) Essential surgery: key messages from Disease Control Priorities, 3rd edn. Lancet 385(9983):2209–2219CrossRefPubMed
5.
Malekzadeh S, Malloy KM, Chu EE et al (2011) Emergencies boot camp: using simulation to onboard residents. Laryngoscope 121:2114–2121CrossRefPubMed
6.
Bair AE, Panacek EA, Wisner DH, Bales R, Sakles JC (2003) Cricothyrotomy: a 5-year experience at one institution. J Emerg Med 24(2):151CrossRefPubMed
7.
Cook TM, Woodall N, Frerk C (2011) Major complications of airway management in the UK: results of the fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. Br J Anaesth 106(5):617–631CrossRefPubMed
8.
Zirkle M, Blum R, Raemer DB, Healy G, Roberson DW (2005) Teaching emergency airway management using medical simulation: a pilot program. Laryngoscope 115:495–500CrossRefPubMed
9.
Reznek M, Harter P, Krummel T (2002) Virtual reality and simulation: training the future emergency physician. Acad Emerg Med 9:78–87CrossRefPubMed
10.
Jayaraman V, Feeney JM, Brautigam RT et al (2014) The use of simulation procedural training to improve self-efficacy, knowledge, and skill to perform cricothyroidotomy. Am Surg 80(4):377–381PubMed
11.
Kennedy CC, Cannon EK, Warner DO, Cook DA (2014) Advanced airway management simulation training in medical education: a systematic review and meta-analysis. Crit Care Med 42(1):169–178CrossRefPubMed
12.
13.
Jowett N, LeBlanc V, Xeroulis G et al (2007) Surgical skill acquisition with self-directed practice using computer-based video training. Am J Surg 193:237–242CrossRefPubMed
14.
Brofeldt T, Panacek EA, Richards JR (1996) An easy cricothyrotomy approach: the rapid four-step technique. Acad Emerg Med 3:1060–1063CrossRefPubMed
15.
Melchiors J, Todsen T, Konge L, Charabi B, von Buchwald C (2016) Cricothyroidotomy—the emergency surgical airway. Head Neck 38(7):1129–1131CrossRefPubMed
16.
Wong DT, Prabhu AJ, Coloma M et al (2003) What is the minimum training required for successful cricothyroidotomy? Anesthesiology 98:349–353CrossRefPubMed
17.
Melchiors J, Todsen T, Nilsson P et al (2015) Preparing for emergency: a valid, reliable assessment tool for emergency cricothyroidotomy skills. Otolaryngol Head Neck Surg 152(2):260–265CrossRefPubMed
18.
Reznick RK, MacRae H (2006) Teaching surgical skills—changes in the wind. N Engl J Med 355:2664–2669CrossRefPubMed
19.
20.
Friedman Z, You-Ten KE, Bould MD et al (2008) Teaching lifesaving procedures: the impact of model fidelity on acquisition and transfer of cricothyrotomy skills to performance on cadavers. Anesth Analg 107:1663–1669CrossRefPubMed
21.
Boet S, Borges BCR, Naik VN et al (2011) Complex procedural skills are retained for a minimum of 1 year after a single high-fidelity simulation training session. Br J Anaesth 107(4):533–539CrossRefPubMed
22.
Broudy HS (1977) Types of knowledge and purposes of education. In: Anderson RC, Spiro RJ, Montague WE (eds) Schooling and the acquisition of knowledge. Erlbaum, Hillsdale, pp 1–17
23.
Daniel M, Parkin IG, Bradley PJ (2006) Anatomy and head and neck surgery. ENT News 15:78–80
24.
Villamaria FJ, Pliego JF, Wehbe-Janek H et al (2008) Using simulation to orient code blue teams to a new hospital facility. Simul Healthc 3(4):209–216CrossRefPubMed
25.
Shetty K, Nayyar V, Stachowski E et al (2013) Training for cricothyroidotomy. Anaesth Intensive Care 41:623–630PubMed
26.
Sulaiman L, Tighe SQM, Nelson RA (2006) Surgical vs wire-guided cricothyroidotomy: a randomised crossover study of cuffed and uncuffed tracheal tube insertion. Anaesthesia 61:565–570CrossRefPubMed
27.
Vadodaria BS, Gandhi SD, McIndoe AK (2004) Comparison of four different emergency airway access equipment sets on a human patient simulator. Anaesthesia 59:73–99CrossRefPubMed
28.
Assmann NM, Wong DT, Morales E (2007) A comparison of a new indicator-guided with a conventional wire-guided percutaneous cricothyroidotomy device in mannequins. Anesth Analg 105:148–154CrossRefPubMed
29.
Brydges R, Nair P, Ma I et al (2012) Directed self-regulated learning versus instructor-regulated learning in simulation training. Med Educ 46:648–656CrossRefPubMed
30.
Brydges R, Carnahan H, Safir O et al (2009) How effective is self-guided learning of clinical technical skills? It’s all about process. Med Educ 43:507–515CrossRefPubMed
31.
Strandbygaard J, Bjerrum F, Maagaard M (2013) Instructor feedback versus no instructor feedback on performance in a laparoscopic virtual reality simulator: a randomized trial. Ann Surg 257(5):839–844CrossRefPubMed
32.
Vedel C, Bjerrum F, Mahmood B et al (2015) Medical students as facilitators for laparoscopic simulator training. J Surg Educ 72(3):446–451CrossRefPubMed
33.
Barsuk JH, McGaghie WC, Cohen ER, O’Leary KJ, Wayne DB (2009) Simulation-based mastery learning reduces complications during central venous catheter insertion in a medical intensive care unit. Crit Care Med 37(10):2697–2701CrossRefPubMed
34.
Cook DA, Brydges R, Zendejas B, Hamstra SJ, Hatala R (2013) Mastery learning for health professionals using technology-enhanced simulation: a systematic review and meta-analysis. Acad Med 88:1178–1186CrossRefPubMed
Metadata
Title
Self-directed simulation-based training of emergency cricothyroidotomy: a route to lifesaving skills
Authors
Jacob Melchiors
Tobias Todsen
Philip Nilsson
Andreas Pagh Kohl
Morten Bøttger
Birgitte Charabi
Lars Konge
Christian von Buchwald
Publication date
01-12-2016
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 12/2016
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-016-4169-0

Other articles of this Issue 12/2016

European Archives of Oto-Rhino-Laryngology 12/2016 Go to the issue

Rhinology

A modification of endoscopic endonasal approach for management of encephaloceles in sphenoid sinus lateral recess

Head and Neck

Prevalence of human papillomavirus in oral squamous cell carcinomas in northern Spain

Letter to the Editor

“Dry”, “moist”, and “wet” status of the middle ear in the regeneration of the eardrum

Otology

Long term results of the titanium clip prosthesis

Otology

Predisposing factors for adverse skin reactions with percutaneous bone anchored hearing devices implanted with skin reduction techniques

Otology

Skin flap complications after cochlear implantations