Localisation of the cricothyroid membrane by digital palpation in the emergency department

Alshareef, Hiba; Saawi, Abdulaziz Al; Almazroua, Faisal; Alyami, Hadi; Reilly, Gerard O’; Mitra, Biswadev

doi:10.1136/postgradmedj-2018-135828

Cited by 7 publications

(3 citation statements)

References 14 publications

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“…Residents have a minimum number of procedures they need to complete in order to progress to independent practice . Prior studies have revealed no gender differences in procedural outcomes among EM physicians including first pass-intubation success and accuracy of cricothyroid membrane identification . However, both the Dayal et al and Santen et al studies revealed that among EM trainees, women residents lag behind men in achieving procedural subcompetency scores.…”

Section: Discussionmentioning

confidence: 95%

“…31 Prior studies have revealed no gender differences in procedural outcomes among EM physicians including first pass-intubation success 32 and accuracy of cricothyroid membrane identification. 33 However, both the Dayal et al 10 and Santen et al 12 studies revealed that among EM trainees, women residents lag behind men in achieving procedural subcompetency scores. Our study findings suggest that among women residents who are assessed as performing below level in procedural skills, competency with procedure may be conflated with confidence in executing the procedure.…”

Section: Discussionmentioning

confidence: 99%

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Gender Differences in Emergency Medicine Attending Physician Comments to Residents: A Qualitative Analysis

et al. 2022

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ImportancePrior studies have revealed gender differences in the milestone and clinical competency committee assessment of emergency medicine (EM) residents.ObjectiveTo explore gender disparities and the reasons for such disparities in the narrative comments from EM attending physicians to EM residents.Design, Setting, and ParticipantsThis multicenter qualitative analysis examined 10 488 narrative comments among EM faculty and EM residents between 2015 to 2018 in 5 EM training programs in the US. Data were analyzed from 2019 to 2021.Main Outcomes and MeasuresDifferences in narrative comments by gender and study site. Qualitative analysis included deidentification and iterative coding of the data set using an axial coding approach, with double coding of 20% of the comments at random to assess intercoder reliability (κ, 0.84). The authors reviewed the unmasked coded data set to identify emerging themes. Summary statistics were calculated for the number of narrative comments and their coded themes by gender and study site. χ2 tests were used to determine differences in the proportion of narrative comments by gender of faculty and resident.ResultsIn this study of 283 EM residents, of whom 113 (40%) identified as women, and 277 EM attending physicians, of whom 95 (34%) identified as women, there were notable gender differences in the content of the narrative comments from faculty to residents. Men faculty, compared with women faculty, were more likely to provide either nonspecific comments (115 of 182 [63.2%] vs 40 of 95 [42.1%]), or no comments (3387 of 10 496 [32.3%] vs 1169 of 4548 [25.7%]; P &lt; .001) to men and women residents. Compared with men residents, more women residents were told that they were performing below level by men and women faculty (36 of 113 [31.9%] vs 43 of 170 [25.3%]), with the most common theme including lack of confidence with procedural skills.Conclusions and RelevanceIn this qualitative study of narrative comments provided by EM attending physicians to residents, multiple modifiable contributors to gender disparities in assessment were identified, including the presence, content, and specificity of comments. Among women residents, procedural competency was associated with being conflated with procedural confidence. These findings can inform interventions to improve parity in assessment across graduate medical education.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Gender Differences in Emergency Medicine Attending Physician Comments to Residents: A Qualitative Analysis

et al. 2022

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“…For this reason, it is recommended to have an advanced management plan for the emergent airway that includes surgical cricothyroidotomy in case of airway loss [ 17 ]. However, it has been shown that the ability to localize the cricothyroid membrane by trained personnel is limited [ 18 ].…”

Section: Protocolmentioning

confidence: 99%

Ultrasound-guided percutaneous tracheostomy: a risk-based protocol

Pérez,

Ospina-Castañeda,

Barrios-Martínez

et al. 2024

Ultrasound J

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The role of ultrasound in front-of-neck access for cricothyroid membrane identification: A systematic review

Rai

You-Ten

Zasso

et al. 2020

Journal of Critical Care

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Localisation of the cricothyroid membrane by digital palpation in the emergency department

Abstract: Clinical localisation of CTM by emergency medicine trainees was poor even in non-stressful settings, and warrants further dedicated education and/or use of adjunct techniques.

Cited by 7 publications

References 14 publications

Gender Differences in Emergency Medicine Attending Physician Comments to Residents: A Qualitative Analysis

Gender Differences in Emergency Medicine Attending Physician Comments to Residents: A Qualitative Analysis

Ultrasound-guided percutaneous tracheostomy: a risk-based protocol

The role of ultrasound in front-of-neck access for cricothyroid membrane identification: A systematic review

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