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Intraoperative Accidental Extubation during Thyroidectomy in a Known Difficult-Airway Patient: An Adult Simulation Case for Anesthesiology Residents

Intraoperative accidental extubation on a known difficult-airway patient requires prompt attention. A good understanding of the steps to re-establish the airway is critical, especially when the patient is known to have a difficult airway documented or discovered on induction or acquires a difficult...

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Autores principales: Okano, David R., Perez Toledo, Javier A., Mitchell, Sally A., Cartwright, Johnny F., Moore, Christopher, Boyer, Tanna J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9601688/
https://www.ncbi.nlm.nih.gov/pubmed/36292458
http://dx.doi.org/10.3390/healthcare10102013
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author Okano, David R.
Perez Toledo, Javier A.
Mitchell, Sally A.
Cartwright, Johnny F.
Moore, Christopher
Boyer, Tanna J.
author_facet Okano, David R.
Perez Toledo, Javier A.
Mitchell, Sally A.
Cartwright, Johnny F.
Moore, Christopher
Boyer, Tanna J.
author_sort Okano, David R.
collection PubMed
description Intraoperative accidental extubation on a known difficult-airway patient requires prompt attention. A good understanding of the steps to re-establish the airway is critical, especially when the patient is known to have a difficult airway documented or discovered on induction or acquires a difficult airway secondary to intraoperative events. The situation becomes even more complicated if the case has been handed off to another anesthesiologist, where specific and detailed information may not have been conveyed. This simulation was designed to train first-year clinical anesthesia residents. It was a 50 min encounter that focused on the management of complete loss of an airway during a thyroidectomy on a known difficult-airway patient. The endotracheal tube dislodgement was simulated by deliberate tube manipulation through the cervical access window of the mannequin. Learners received a formative assessment of their performance during the debrief, and most of the residents met the educational objectives. Learners were asked to complete a survey of their experience, and the feedback was positive and constructive. The response rate was 68% (17/25). Our simulation program helped anesthesiology residents develop intraoperative emergency airway management skills in a safe environment, as well as foster communication skills among anesthesiologists and the surgery team.
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spelling pubmed-96016882022-10-27 Intraoperative Accidental Extubation during Thyroidectomy in a Known Difficult-Airway Patient: An Adult Simulation Case for Anesthesiology Residents Okano, David R. Perez Toledo, Javier A. Mitchell, Sally A. Cartwright, Johnny F. Moore, Christopher Boyer, Tanna J. Healthcare (Basel) Article Intraoperative accidental extubation on a known difficult-airway patient requires prompt attention. A good understanding of the steps to re-establish the airway is critical, especially when the patient is known to have a difficult airway documented or discovered on induction or acquires a difficult airway secondary to intraoperative events. The situation becomes even more complicated if the case has been handed off to another anesthesiologist, where specific and detailed information may not have been conveyed. This simulation was designed to train first-year clinical anesthesia residents. It was a 50 min encounter that focused on the management of complete loss of an airway during a thyroidectomy on a known difficult-airway patient. The endotracheal tube dislodgement was simulated by deliberate tube manipulation through the cervical access window of the mannequin. Learners received a formative assessment of their performance during the debrief, and most of the residents met the educational objectives. Learners were asked to complete a survey of their experience, and the feedback was positive and constructive. The response rate was 68% (17/25). Our simulation program helped anesthesiology residents develop intraoperative emergency airway management skills in a safe environment, as well as foster communication skills among anesthesiologists and the surgery team. MDPI 2022-10-12 /pmc/articles/PMC9601688/ /pubmed/36292458 http://dx.doi.org/10.3390/healthcare10102013 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Okano, David R.
Perez Toledo, Javier A.
Mitchell, Sally A.
Cartwright, Johnny F.
Moore, Christopher
Boyer, Tanna J.
Intraoperative Accidental Extubation during Thyroidectomy in a Known Difficult-Airway Patient: An Adult Simulation Case for Anesthesiology Residents
title Intraoperative Accidental Extubation during Thyroidectomy in a Known Difficult-Airway Patient: An Adult Simulation Case for Anesthesiology Residents
title_full Intraoperative Accidental Extubation during Thyroidectomy in a Known Difficult-Airway Patient: An Adult Simulation Case for Anesthesiology Residents
title_fullStr Intraoperative Accidental Extubation during Thyroidectomy in a Known Difficult-Airway Patient: An Adult Simulation Case for Anesthesiology Residents
title_full_unstemmed Intraoperative Accidental Extubation during Thyroidectomy in a Known Difficult-Airway Patient: An Adult Simulation Case for Anesthesiology Residents
title_short Intraoperative Accidental Extubation during Thyroidectomy in a Known Difficult-Airway Patient: An Adult Simulation Case for Anesthesiology Residents
title_sort intraoperative accidental extubation during thyroidectomy in a known difficult-airway patient: an adult simulation case for anesthesiology residents
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9601688/
https://www.ncbi.nlm.nih.gov/pubmed/36292458
http://dx.doi.org/10.3390/healthcare10102013
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