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Evaluation of an Innovative Bleeding Cricothyrotomy Model

Objectives Emergency medicine (EM) residents are required to perform a cricothyrotomy during training as per the Accreditation Council for Graduate Medical Education (ACGME) guidelines. Cricothyrotomy is a rare procedure, comprising 0.45% of emergency department airway management procedures. Procedu...

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Autores principales: Hughes, Kate E, Biffar, David, Ahanonu, Eze O, Cahir, Thomas M, Hamilton, Allan, Sakles, John C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248871/
https://www.ncbi.nlm.nih.gov/pubmed/30473960
http://dx.doi.org/10.7759/cureus.3327
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author Hughes, Kate E
Biffar, David
Ahanonu, Eze O
Cahir, Thomas M
Hamilton, Allan
Sakles, John C
author_facet Hughes, Kate E
Biffar, David
Ahanonu, Eze O
Cahir, Thomas M
Hamilton, Allan
Sakles, John C
author_sort Hughes, Kate E
collection PubMed
description Objectives Emergency medicine (EM) residents are required to perform a cricothyrotomy during training as per the Accreditation Council for Graduate Medical Education (ACGME) guidelines. Cricothyrotomy is a rare procedure, comprising 0.45% of emergency department airway management procedures. Procedural competence in utilizing a realistic trainer is of utmost importance. We have developed a cricothyrotomy trainer using a fused deposition modeling (FDM) three-dimensional (3D) printer and innovative bleeding tissue to enhance fidelity. We aim to evaluate the trainer’s realism. Methods Implementation occurred during a difficult airway educational lab for EM residents in April 2018. Participants completed anonymous written surveys after performing a cricothyrotomy on the trainer. The survey evaluated the realism of the trainer and compared it to other available models by utilizing five-point visual analog scales (VAS). The participants rated their comfort level in performing the procedure pre- and post-educational lab on a five-point VAS. Demographic data included postgraduate year, prior clinical cricothyrotomy experience as a primary operator versus as an assistant, and previous trainer experience. The survey included open-response suggestions for trainer improvement.  Results Forty-three EM residents completed the survey (82.7%, 43/52). The mean realism rating of the trainer was 3.81 (95% CI = 3.54-4.1). The participants reported previous training on cadaver (62.8%, 27/43), porcine (46.5%, 20/43), and manikin (67.4%, 29/43) models prior to using this trainer. The bleeding cricothyrotomy trainer was rated higher than other models (4.45, 95% CI = 4.28-4.63). Participants noted improved comfort with performing the cricothyrotomy after the educational lab (average improvement of 1.23±0.75). Participants specifically commented on the realism of the bleeding and skin texture; however, they also recommended a reduction in the size of the cricothyroid membrane space.  Conclusion The innovative bleeding cricothyrotomy trainer has greater fidelity and reported superiority when compared to other commonly used nonbleeding models. This trainer provides a more advanced platform to teach an infrequent yet critical procedural skill to emergency medicine residents.
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spelling pubmed-62488712018-11-23 Evaluation of an Innovative Bleeding Cricothyrotomy Model Hughes, Kate E Biffar, David Ahanonu, Eze O Cahir, Thomas M Hamilton, Allan Sakles, John C Cureus Emergency Medicine Objectives Emergency medicine (EM) residents are required to perform a cricothyrotomy during training as per the Accreditation Council for Graduate Medical Education (ACGME) guidelines. Cricothyrotomy is a rare procedure, comprising 0.45% of emergency department airway management procedures. Procedural competence in utilizing a realistic trainer is of utmost importance. We have developed a cricothyrotomy trainer using a fused deposition modeling (FDM) three-dimensional (3D) printer and innovative bleeding tissue to enhance fidelity. We aim to evaluate the trainer’s realism. Methods Implementation occurred during a difficult airway educational lab for EM residents in April 2018. Participants completed anonymous written surveys after performing a cricothyrotomy on the trainer. The survey evaluated the realism of the trainer and compared it to other available models by utilizing five-point visual analog scales (VAS). The participants rated their comfort level in performing the procedure pre- and post-educational lab on a five-point VAS. Demographic data included postgraduate year, prior clinical cricothyrotomy experience as a primary operator versus as an assistant, and previous trainer experience. The survey included open-response suggestions for trainer improvement.  Results Forty-three EM residents completed the survey (82.7%, 43/52). The mean realism rating of the trainer was 3.81 (95% CI = 3.54-4.1). The participants reported previous training on cadaver (62.8%, 27/43), porcine (46.5%, 20/43), and manikin (67.4%, 29/43) models prior to using this trainer. The bleeding cricothyrotomy trainer was rated higher than other models (4.45, 95% CI = 4.28-4.63). Participants noted improved comfort with performing the cricothyrotomy after the educational lab (average improvement of 1.23±0.75). Participants specifically commented on the realism of the bleeding and skin texture; however, they also recommended a reduction in the size of the cricothyroid membrane space.  Conclusion The innovative bleeding cricothyrotomy trainer has greater fidelity and reported superiority when compared to other commonly used nonbleeding models. This trainer provides a more advanced platform to teach an infrequent yet critical procedural skill to emergency medicine residents. Cureus 2018-09-18 /pmc/articles/PMC6248871/ /pubmed/30473960 http://dx.doi.org/10.7759/cureus.3327 Text en Copyright © 2018, Hughes et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Emergency Medicine
Hughes, Kate E
Biffar, David
Ahanonu, Eze O
Cahir, Thomas M
Hamilton, Allan
Sakles, John C
Evaluation of an Innovative Bleeding Cricothyrotomy Model
title Evaluation of an Innovative Bleeding Cricothyrotomy Model
title_full Evaluation of an Innovative Bleeding Cricothyrotomy Model
title_fullStr Evaluation of an Innovative Bleeding Cricothyrotomy Model
title_full_unstemmed Evaluation of an Innovative Bleeding Cricothyrotomy Model
title_short Evaluation of an Innovative Bleeding Cricothyrotomy Model
title_sort evaluation of an innovative bleeding cricothyrotomy model
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248871/
https://www.ncbi.nlm.nih.gov/pubmed/30473960
http://dx.doi.org/10.7759/cureus.3327
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