Comparison of Manikin Versus Porcine Trachea Models When Teaching Emergent Cricothyroidotomy Among Emergency Medicine Residents

Abstract

Objectives: Emergent cricothyroidotomy (EC) is a rarely used yet lifesaving procedure that is important for an emergency physician to master throughout his or her training. We evaluated the difference in utilization of a manikin or porcine model among emergency medicine (EM) residents when teaching EC. We also evaluated the difference in the models using two different commonly utilized and taught techniques: "scalpel-finger-bougie" (SFB) technique and the Melker technique (MT).Methods: This was a prospective crossover design. Instructions about the procedure were provided; study participants were randomly assigned to one of two groups and performed cricothyrotomy on both manikin and porcine simulators using both the Melker and the SFB techniques. Each group was started with the technique on the second simulator opposite what they started with on the first simulator. After the procedures, study participants completed a questionnaire that used the same format for both groups. All survey questions required a 7-point Likert scale response. Confidence, difficulty, reality of the anatomy, and landmarks were compared.Results: Fifteen EM residents participated in the study. Compared to the porcine-first group, the manikin-first group rated the anatomy more realistic (question 5) after their first attempt (6.29 vs. 5.87) than their second attempt (using the porcine model; 4.29 vs. 5.62; main effect for attempts [first vs. second] p = 0.027; interaction p = 0.074). Interestingly, the porcine model-first group rated the landmarks (question 6) significantly easier to find in both attempts (6.87 vs. 5.86 on the first attempt and 6.50 vs. 5.57 on the second attempt; p = 0.012). Twelve participants (80%) chose SFB as their preferred technique to use in real-life scenario.Conclusion: The Manikin model tends to be more realistic in cricothyrotomy simulation than the porcine model.The influence of fresh pig skin overlying the porcine model may require further research. Landmark identification during the procedure was easier on both models when participants start with the porcine model. Participants prefer the SFB over MT if faced with a real-life scenario.From the

Performance Based Evaluation of Cricothyroidotomy Simulators for Training

“…Participants' comments suggest that longer procedure completion times during the posttest may have reflected differences in tissue rigidity and anatomical structure between the trainers and the porcine trachea, a finding supported by realism questionnaires administered by Gustafson, Hensley, Dotson, Broce, and Tager (2019). However, our performance findings are contrary to investigation showing that performance on porcine and manikin simulator training led to comparable experiences (Pandian et al, 2020).…”

Features of mastering practical skills by students during the COVID-19 pandemic using simulation training methods

“…SimuLab's Surgical Trauma Training Manikin (SKU: TM-5138) was used for mastering and assessing practical skills. It is a high quality simulation mannequin that could be used in Simulation-Based Medical Education for all students, interns, residents, and medical doctors [13,14].…”

Teachers should apply the principle of reduction for more sustainable surgical simulation practice: the example of training pharyngolaryngeal surgery in a porcine model

“…In our experience, the use of a dead porcine model provides satisfactory anatomical and haptic fidelity for surgical simulation of the central neck compartment, while diminishing the environmental costs, handling, paperwork, and ethical issues of using live animals. It is thus possible to simulate most surgical procedures on the upper airway, such as tracheotomy ( 21 – 23 ), cricothyroidotomy ( 24 ), laryngotracheoplasty ( 23 ), total laryngectomy ( 21 ) or even some endolaryngeal surgical procedures ( 25 ).…”