Effect of Simulation Training on Compliance with Difficult Airway Management Algorithms, Technical Ability, and Skills Retention for Emergency Cricothyrotomy

Hubert, V.; Duwat, A.; Deransy, Romain; Mahjoub, Yazine; Dupont, Hervé

doi:10.1097/aln.0000000000000138

Cited by 92 publications

(66 citation statements)

References 37 publications

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“…20 Hubert and colleagues also showed that simulation and airway technical skill training significantly improves anesthesia residents' compliance with difficult airway guidelines. 21 On the other hand, technical skill uncertainty in internal medicine residents resulted in delays to indicated medical decisions and in some cases compromised patient outcomes. 22 Our study not only reinforces the importance of hands-on training for improving technical skills, [18][19][20][21][22] it demonstrates that it may enhance adherence to airway guidelines in a simulated CICO scenario.…”

Section: Discussionmentioning

confidence: 99%

Cricothyrotomy training increases adherence to the ASA difficult airway algorithm in a simulated crisis: a randomized controlled trial

You-Ten

Bould

Friedman

et al. 2014

Can J Anesth/J Can Anesth

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Section: Discussionmentioning

confidence: 99%

Cricothyrotomy training increases adherence to the ASA difficult airway algorithm in a simulated crisis: a randomized controlled trial

You-Ten

Bould

Friedman

et al. 2014

Can J Anesth/J Can Anesth

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“…Advances in simulation technology have enabled the assessment of procedures in the simulation laboratory without causing potential harm to patients. A full-body patient computerized mannequin can provide physiological feedback similar to patient feedback in a real-life situation, 4 and it can facilitate recreating crisis situations where life-saving procedures must be performed quickly to prevent further physiological compromise. 5 For rarely performed procedures, such as a cricothyrotomy, simulation is the only alternative for assessment.…”

Section: Résumémentioning

confidence: 99%

“…The simulation room included a fully computerized SimMan, full monitors (electrocardiogram, noninvasive blood pressure, pulse oximeter, end-tidal capnogram), alarms, and basic airway devices. The airway devices included a Macintosh laryngoscope blade (in sizes 3 and 4), a Miller laryngoscope blade, a gum elastic bougie, and a laryngeal maks (in sizes [3][4][5]. A GlideScope Ò video laryngoscope (Verathon, Burnaby, BC, Canada) and a fibreoptic bronchoscope were supplied on request.…”

Section: Test Scenarios: Cs and Ncsmentioning

confidence: 99%

Role of contextualizing a crisis scenario on the performance of a cricothyrotomy procedural task

You-Ten

Wong

Arzola

et al. 2015

Can J Anesth/J Can Anesth

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Purpose Simulation is an important alternative to evaluate cricothyrotomy, a rare life-saving procedure. This crossover study aimed to determine whether contextualization of a crisis scenario would impact the performance of a cricothyrotomy procedural task. Methods Sixty-five anesthesia assistants and emergency medicine and anesthesia residents underwent a teaching session in surgical cricothyrotomy using one of two sets of cricothyrotomy kits: the Portex 6.0 and Melker 3.5 (n = 32) or the Portex 6.0 and Melker 5.0 (n = 33). Within six weeks following the session, the participants performed cricothyrotomies on a full-body patient mannequin simulator coupled with a porcine larynx (tissuemannequin simulator) using the assigned two kits in a ''cannot intubate, cannot ventilate'' (CICV) contextualized scenario (CS) and in a CICV verbalized non-contextualized scenario (NCS). Each participant performed a total of four cricothyrotomies using the two kits in the two scenarios. The primary outcome measure was insertion time, and secondary outcome measures were severity of injuries and failure rate. Outcome measures were compared between scenarios for each kit. Results Mean (SD) insertion time for a successful cricothyrotomy was not significantly different between NCS and CS for the Melker 3.5 [83.0 (45.0) sec vs 63.3 (36.1) sec, respectively; P = 0.96; mean difference (MD), 19.7 sec; 95% confidence interval (CI), -1.9 to 41.3], the Melker 5.0 [86.5 (36.8) sec vs 107.1 (55.6) sec, respectively; P = 0.11; MD, -20.6 sec; 95% CI, -44.9 to 3.7], and the Portex 6.0 [59.5 (35.5) sec vs 59.0 (35.0) sec, respectively; P = 0.95; MD, 0.5 sec; 95% CI, -13.2 to 14.2]. Failure rate and severity of injuries, measured as mean average injury score for each kit, were also similar between scenarios. Conclusions Contextualization of a crisis scenario did not affect the performance of a cricothyrotomy procedural task on a tissue-mannequin simulator. These findings may have implications when considering the feasibility and cost-effectiveness for assessing the performance of cricothyrotomy procedural tasks. RésuméObjectif La simulation est une alternative importante pour évaluer la cricothyrotomie, une intervention de sauvetage rare. Cette étude croisée avait pour objectif de déterminer si la mise en contexte d'un scénario de crise avait un impact sur la performance d'une tâche procédurale de cricothyrotomie.Author contributions Kong E. You-Ten designed the study, conducted the study, analyzed the data, and wrote the manuscript. Catherine Wong helped analyze the data and write the manuscript. Catherine Wong, Cristian Arzola, Jessica Cheung, and Naveed Siddiqui helped conduct the study. Catherine Wong, Cristian Arzola, Jessica Cheung, Naveed Siddiqui, Zeev Friedman, and Sev Perelman helped review the manuscript. Zeev Friedman and Sev Perelman helped design the study.

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“…Studies in other fields have also only reevaluated subjects 4 to 6 weeks after the intervention. Of note, 2 studies in anesthesiology 8,9 stood out because they evaluated the retention of skills to perform an emergency cricothyroidotomy up to 1 year after a simulation was conducted. Another study 10 evaluated the loss of skills monthly after simulation; deterioration of skills started 4 months later but less practice was required to regain skills than originally required.…”

Section: What Was Known and Gapmentioning

confidence: 99%

Objective Structured Assessment of Technical Skills to Teach and Study Retention of Fourth-Degree Laceration Repair Skills

Martinez¹,

Cassling²,

Keller³

2015

Journal of Graduate Medical Education

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IntroductionFourth-degree lacerations are infrequent but serious complications that involve the tearing of the vaginal epithelium, tissues of the perineal body, anal sphincter complex, and the rectal mucosa at the time of vaginal delivery.1 Prior studies 2 have shown a high incidence (up to 60%) of perineal pain, anal incontinence, and dyspareunia after severe perineal injury during childbirth. Perineal lacerations after childbirth are classified as first-, second-, third-, and fourth-degree on the basis of the tissues involved; third-and fourth-degree are considered serious because the external anal sphincter is involved in the laceration. Unfortunately, residents are universally undertrained in the repair of fourth-degree lacerations because of their infrequency. However, it is vital that graduating residents be able to repair a fourth-degree laceration even if they did not encounter one during their training. Prior research has demonstrated that the combination of the Objective Structured Assessment of Technical Skills (OSATS) and a written examination before and after an educational workshop is a valid and reliable way of assessing residents' improvement in surgical skills and knowledge in the repair of fourth-degree lacerations. 4,5We sought to expand this work by including a 6-month follow-up OSATS and written examination to evaluate the retention of information learned during the workshop. We hypothesized that residents' technical skills and knowledge to repair fourth-degree perineal lacerations will reflect AbstractBackground Fourth-degree perineal lacerations are a serious but infrequent complication of childbirth.

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Effect of Simulation Training on Compliance with Difficult Airway Management Algorithms, Technical Ability, and Skills Retention for Emergency Cricothyrotomy

Abstract: The training session significantly improved the residents' compliance with guidelines and their performance of cricothyrotomy.

Cited by 92 publications

References 37 publications

Cricothyrotomy training increases adherence to the ASA difficult airway algorithm in a simulated crisis: a randomized controlled trial

Cricothyrotomy training increases adherence to the ASA difficult airway algorithm in a simulated crisis: a randomized controlled trial

Role of contextualizing a crisis scenario on the performance of a cricothyrotomy procedural task

Objective Structured Assessment of Technical Skills to Teach and Study Retention of Fourth-Degree Laceration Repair Skills

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