A novel method for improving chest tube insertion skills among medical interns

Tatlı, Özgür; Turkmen, Süha; İmamoğlu, Melih; Karaca, Yunus; Çiçek, Mustafa Cüneyt; Yadigaroğlu, Metin; Bayrak, Selen T.; Asik, Olgun; Topbaş, Murat; Türedi, Süleyman

doi:10.15537/smj.2017.10.21021

Cited by 12 publications

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References 11 publications

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“…18 The risk of complications with this procedure such as bleeding, vascular and solid organ injuries is more in inexpert hand. 19 A poorly placed tube causes undrained pneumothorax, haemothorax, a post removal pneumothorax, or empyema, all of which leads to increase the length of hospital stay. 20 The overall complication rate associated with this procedure is 30% in all operators.…”

Section: Evaluation Of Percutaneous Tube Thoracostomy Performed By Trainee In Both Trauma and Non-trauma Patientsmentioning

confidence: 99%

Evaluation of Percutaneous tube Thoracostomy Performed by Trainee in both Trauma and non-Trauma Patients

Maula¹,

Alam²,

Khalil³

et al. 2021

Bangladesh Crit Care J

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Background: Percutaneous Tube Thoracostomy (PTT) is an invasive procedure that can save life now and then in different traumatic and non-traumatic conditions. But still it is an enigma; how our trainee surgeons are at home in this procedure. Objectives: To evaluate the outcome of the percutaneous tube thoracostomy performed by trainee in both trauma and non-trauma patients. Study design: Prospective, Observational study. Duration of study was September, 2019 to February, 2019. Methods: All patients who need PTT in traumatic and non-traumatic conditions were selected by purposive sampling. Thereafter, they were scrutinized according to eligibility criteria and 96 patients were finalized. A pre-tested, observation based, peer-reviewed data collection sheet was prepared before study. Data regarding clinical and surgical outcome profile were recorded. Data were compiled, edited, analyzed. Results: Among 96 patients, the highest 32.29% belonged to age group 31-40 years and lowest 9.37% belonged to age group ≤20. The mean age of the respondents was 29.19±9.81. We found out of 96 patients, 70(72.91%) were indicated PTT for traumatic conditions and rest 26(27.08%) were indicated PTT for non-traumatic chest condition where 36(37.5%) had simple penumothorax, 21(21.87%) haemothorax, 14(14.58%) massive pleural effusion, 13(13.54%) tension pneumothorax, 10(10.41%) haemopneumothorax, and 2(2.08%) had pyothorax respectively. In 53.12% patients had right sided intercostal chest tube (ICT) insertion whereas 46.87% had left sided ICT insertion. In our study, 89.55 % tube was placed at normal anatomical position. Besides, 10.41% tube thoracostomy were performed deviated from anatomical site. Among 96 patients 62.5% patients had length of incision 2-3cm, 35.41% had >3cm and 2.08% had <2cm respectively. Out of 96 patients 75(78.13%) showed uneventful outcome whereas 21(21.87%) had complications including 11.15%(11) each had wound infection, 4.46%(4) subcutaneous emphysema, 4.28%(3) drain auto expulsion, 2.85%(2) hemorrhage, 1.45%(1) had non-functioning drain and empyema with ascending infection respectively (p=<0.05). Conclusion: PTT is a life saving procedure that is most frequently implemented in chest trauma patients of our country. In majority cases, outcome of PTT were uneventful (78.13). Besides this more than one third of patient had length of incision more than 3 cm that needed extra stitches and 10.41% cases PTT were placed other than the normal anatomical site. Trainees of Dhaka Medical College Hospital are doing well in their performance of PTT insertion but still some anatomical orientations are necessary to avoid operative and post-operative complications Bangladesh Crit Care J March 2021; 9(1): 28-33

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Section: Evaluation Of Percutaneous Tube Thoracostomy Performed By Trainee In Both Trauma and Non-trauma Patientsmentioning

confidence: 99%

Evaluation of Percutaneous tube Thoracostomy Performed by Trainee in both Trauma and non-Trauma Patients

Maula¹,

Alam²,

Khalil³

et al. 2021

Bangladesh Crit Care J

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“…Tatli et al, 2017, and Yong et al, 2019, developed low-cost models for training medicalSociety and Development, v. 11, n. 10, e173111032664, 2022 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v11i10.32664 …”

mentioning

confidence: 99%

Chest tube simulation: experience report and brief review

Fortes

Barros²,

Silva³

et al. 2022

RSD

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Chest tube insertion is one of the most performed surgical procedures in medical practice, being performed in Brazil by both general practitioners and experienced surgeons. This study aimed to report an experience with the application of an animal model to simulate chest drainage, as well as review the scientific literature available on the subject. In our experience, pork rib pieces were used to simulate the human rib cage, where medical students trained the procedure with the help of a thoracic surgeon. The porcine model used proved to be satisfactory, allowing the study of anatomical correlations and surgical technique among the students. In our review, we found 5 other experiences reported, 3 in a synthetic anatomical model, 1 in a porcine model and 1 comparative study between a synthetic model and a cadaver model. All models proved to be efficient for training students, but they present differences in terms of cost and durability, with the synthetic model being the most cost-effective alternative.

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“…Outra forma é avaliar cada tarefa essencial da drenagem através de uma escala de Likert: Incorreto, parcialmente correto e correto com excelência. Essas três definições são convertidas em uma escala numérica para facilitar a análise e comparação dos dados 39 . Os itens práticos a serem analisados variam entre os estudos, não havendo uniformidade 19, 34, 39, 41, .…”

Section: Método De Avaliação De Treinamento De Drenagem De Tóraxunclassified

“…Diferentemente do estudo de Proano et al 19 , optamos por ter uma análise baseada em componentes da habilidade, tais como técnica de incisão na pele, dissecção correta e inspeção digital, em vez de apenas medir o tempo do procedimento. Nesse aspecto, o estudo assemelha-se ao estudo de Tube et al 34 , com a diferença de termos ampliado os quesitos técnicos para avaliação do procedimento de seis para 14, após interpretação do estudo de Tatli et al 39 , cujo checklist abrangia 21 itens, e da diretriz britânica de cirurgia torácica 41 . As principais diferenças do checklist realizado no estudo em relação ao British Thoracic Surgery guidelines 41…”

Section: Critérios De Avaliação Teórica E Práticaunclassified

“…Dessa maneira obtêm-se retenção mais duradoura e maior acurácia na execução da habilidade prática.Diversos estudos demonstraram que o treinamento de drenagem de tórax em ambiente simulado é efetivo49,50,51,38,52 . Entretanto, há limitações referentes ao custo da implementação do laboratório de treinamento, despesas de manutenção, organização do time de docentes e tempo de preparo das atividades39 . Não se sabe qual é a melhor forma de realizar o treinamento cirúrgico.…”

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Comparação do aprendizado de drenagem de tórax entre modelos cadavérico, manequim e suíno com alunos de medicina

Pflug¹

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RESUMORESUMO Pflug, ARM. Comparação do aprendizado de drenagem de tórax entre modelos cadavérico, manequim e suíno com alunos de medicina. [tese]. São Paulo: Faculdade de Medicina, Universidade de São Paulo; 2019. Na drenagem de tórax, a falta de confiança relatada pelos alunos pode implicar em aumento de complicações operatórias. Não se sabe qual modelo de treinamento é mais eficiente para o aprendizado. Alunos da graduação médica, sem treinamento prévio de drenagem de tórax, foram randomizados em três grupos: modelo suíno, cadavérico e manequim. Realizou-se teste escrito antes e após treinamento, além de prova prática, baseada em um checklist de tarefas preconizadas. Essa prova foi realizada no mesmo dia do treinamento e repetida após seis meses (retenção). Posteriormente ao treinamento, uma enquete avaliou o índice de satisfação e o aumento de confiança em realizar o procedimento. Registrou-se a checagem de lateralidade antes de iniciar o procedimento. Foram avaliados 144 alunos, sendo 42 no grupo cadáver, 34 no suíno e 68 no grupo manequim. Os grupos foram considerados homogêneos quanto a idade, sexo e intenção em pós-graduação em cirurgia. As notas do teste teórico, após o treinamento, elevaram-se em todos os modelos. As notas da prova prática logo após e seis meses após o treinamento foram, respectivamente: 86 e 78 no grupo cadavérico, 82 e 78 no suíno e 84 e 79 no grupo com manequins. A taxa de checagem de lateralidade do procedimento foi respectivamente: 78% no modelo cadavérico, 45% no suíno e 84% no modelo com manequins. A percepção de confiança em realizar drenagem de tórax após o treinamento aumentou nos três modelos, sem diferença estatisticamente significativa entre eles. A satisfação com o modelo de treinamento foi 4,82 no cadavérico, 4,67 no suíno e 4,22 em manequins. Conclusão: a nota da prova prática de retenção foi semelhante nos três modelos. No modelo suíno observouse menor taxa de verificação de lateralidade da drenagem, e no modelo manequim, o grau de satisfação foi menor. O grau de confiança e a nota teórica se elevaram nos três modelos. Descritores: Toracostomia, treinamento por simulação, habilidade, modelos animais, cadáver, manequins, estudante de medicina. ABSTRACT ABSTRACT Pflug, ARM. Comparison of chest tube insertion learning between cadaveric, pigs and synthetic models with medicine students. [thesis] São Paulo: School of Medicine, University of São Paulo; 2019.In the chest drainage, the lack of confidence reported by the students may imply an increase in complications. It is not known which training model is more efficient for learning. Medical students, without previous chest drainage training, were randomized into three groups: pigs, cadaveric and synthetic models. Written test was done before and after training, in addition to a practical test, based on a checklist of standardized tasks, performed on the same day and six months after the training. A survey evaluated the satisfaction index and increased in self-confidence in performing the procedure after the surgical training....

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A novel method for improving chest tube insertion skills among medical interns

Cited by 12 publications

References 11 publications

Evaluation of Percutaneous tube Thoracostomy Performed by Trainee in both Trauma and non-Trauma Patients

Evaluation of Percutaneous tube Thoracostomy Performed by Trainee in both Trauma and non-Trauma Patients

Chest tube simulation: experience report and brief review

Comparação do aprendizado de drenagem de tórax entre modelos cadavérico, manequim e suíno com alunos de medicina

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