Cricothyroidotomy Training on Cadavers: a Prospective Study
Černý V., Schreiberová J., Pavlínek O.
Klinika anesteziologie, resuscitace a intenzivní medicíny, Univerzita Karlova v Praze, Lékařská fakultav Hradci Králové, Fakultní nemocnice Hradec Králové, přednosta doc. MUDr. Vladimír Černý, PhD., FCCM |
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Summary:
Objective: Cricothyroidotomy plays on important role in emergency pathway of the difficult airway algorithm, however
emergent cricothyroidotomy is performed infrequently and can be difficult because of the lack of training and skill retention.
The aim of the study was to assess cricothyroidotomy training on cadavers in anaesthesiologists.
Design: prospective observational questionnaire based study.
Settings: Tertiary Care Hospital, Hradec Králové.
Material and methods: All participants performed cricothyroidotomy training procedure on cadavers under the guidance of
the physician skilled in cricothyroidotomy. Each participant had to perform one attempt of cricothyroidotomy without
assistance. All participants were asked to fill in the questionnaire before training – age, sex, certification degree, length of
clinical practice, previous experience with cricothyroidotomy and tracheotomy, degree of willingness (DOW) to perform
cricothyroidotomy in real life was according to assessed the four point scale: 4 = definitely yes anytime if necessary, 3 =
slightly hesitating but yes, 2 = hesitating with great degree of uncertainty, 1 = probably would not perform even if indicated.
After training, DOW to perform cricothyroidotomy and training utility were evaluated. Statistical analysis was performed
using SigmaStat Statistical Software (Wilcoxon Signed Rank Test, Spearman Rank Correlation, p<0.05).
Results: Twenty-two anesthesiologists (7 men, 15 women) completed the study by filling in the questionnaire. Two
participants (ptc.) had previous experience of performing cricothyroidotomy, 8 of tracheotomy. Degree of willingness to
perform cricothyroidotomy before training: 4 (3 ptc.), 3 (13 ptc.), 2 (6 ptc.), 1 (0). There was a significant (p=0.003) increase
of DOW after training: 4 (8 ptc.), 3 (14 ptc.), 2 (0), 1 (0). Positive correlation between previous experience with tracheotomy,
resp. degree of certification and pre-training DOW to perform cricothyroidotomy was found (r=0.47, P=0.02, resp. r=0.62,
P=0.002). All participants of the study considered the training effective.
Conclusion: Cricothyroidotomy training should be a part of emergency airway management practice. Performance of
cricothyroidotomy on cadavers may be possible effective way to increase DOW to perform this procedure in a real-life
situation. Previous experience with tracheotomy, higher degree of certification, male sex are related to higher pre-training
degree of DOW.
Key words:
cricothyroidotomy – training – cadavers
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