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Data from: Cadaveric emergency cricothyrotomy training for non-surgeons using a bronchoscopy-enhanced curriculum

Maloney, Jim1

Research facility: University of Colorado Denver
Published Mar 06, 2023 on Dryad. https://doi.org/10.5061/dryad.73n5tb321

Data files

Mar 06, 2023 version files 775.05 MB

Abstract

Emergency cricothyrotomy training for non-surgeons providing critical care is important as rare “cannot intubate or oxygenate events” may occur multiple times in a provider’s career when surgical expertise is not immediately available. However, such training is highly variable and often infrequent so enhancing these experiences is important.

Our study was performed after implementing a program to train non-surgeon providers on cadaveric donors. Standard training with an instructional video and live coaching was enhanced by bronchoscopic visualization of the trachea allowing participants to review their technique after performing scalpel and Seldinger-technique procedures, and to review their colleagues’ technique on live video. Feasibility was measured through assessing helpfulness for trainees, cost, setup time, quality of images, and operator needs. Footage from the bronchoscopy recordings was analyzed to assess puncture-to-tube time and errors. Participants submitted pre- and post-session surveys assessing their levels of experience and gauging their confidence and anxiety with cricothyrotomies.

We found our training program met feasibility criteria for low costs, setup time, and operator needs. Furthermore, all 24 participants rated the cadaveric session as helpful and demonstrated efficient technique by puncture-to-tube times. Bronchoscopy videos revealed that sharp instrument puncturing of the posterior tracheal wall was common and that improper tube placement occurred but was uncommon. Bronchoscopic enhancement was rated as quite or extremely helpful for visualizing the trachea and to assess depth of instrumentation. There was a significant increase in confidence and decrease in performance anxiety after the session.

Our findings confirm that supplementing cadaveric emergent cricothyrotomy training programs with tracheal bronchoscopy is feasible, helpful to trainees, meets prior documented times for efficient technique, and detects technical errors that would have been missed in a standard training program. Bronchoscopic enhancement is a valuable addition to cricothyrotomy cadaveric training programs and may help avoid real-life complications.