IntroductiondCricothyroidotomy is an advanced and life-saving technique, but it is also a rare and a difficult procedure. The purpose of the present study was to produce a low-cost simulation model with realistic anatomic features to investigate its effectiveness in developing cricothyroidotomy skills. MethodsdThis study was performed at a university simulation center with 57 second-year student paramedics and a cricothyroidotomy simulation model. Total scores were assessed using a checklist. This consisted of 13 steps and was scored as misapplication/omission=0, correct performance and timing with hesitation=1, and correct performance and timing without hesitation=2. One of these steps, local anesthesia of the area if time is available, was not performed owing to time limitations. The highest possible score was 24. Data are presented as mean±SD with range, as appropriate. Normal distribution was evaluated using the Kolmogorov-Smirnov test, Student t test, and Mann-Whitney U test, and correlation analysis was used for statistical analysis. ResultsdStudents completed the cricothyroidotomy procedure steps in 116±46 (55e238) s. At performance assessment, the score achieved was 12±5 (2e24). The highest total score of 24 was achieved by 3 students (5%). Total scores exhibited negative and significant correlation with procedure time (r=-0.403, P=0.002). ConclusionsdThe model developed in this study is an inexpensive and effective method that can be used in cricothyroidotomy training for student paramedics. We think that repeating the cricothyroidotomy procedure on the model will increase success levels.
for prospective, interventional studies comparing outcomes of patients treated and/or transported by either PS-HEMS or GEMS. Outcomes of interest were mortality, time to hospital, and quality of life (QoL). Results Of 16 studies eligible for inclusion, 12 reported on trauma patients, four on cardiac patients, and one study on stroke patients. Three studies showed significantly different mortality rates (all on trauma patients) with lower 30 day mortality (OR=0.68 [0.47-0.98] and OR=0.41 [0.2-0.87]) and lower in-hospital mortality (OR=0.29 [0.1-0.82]) for PS-HEMS compared to GEMS. Eight studies showed significantly different time to hospital between patients transported with PS-HEMS compared to GEMS. In cardiac patients, time was significantly lower (84 vs 102 min and 71 vs 78 min, both p<0.01). Amongst trauma patients, three showed decreased time with PS-HEMS and three showed increased time. Three studies reported QoL on trauma patients, but no benefit of PS-HEMS was found. Conclusion In this systematic review we found a possible survival benefit for trauma patients treated and transported with PS-HEMS compared to GEMS. Furthermore, we found that time to hospital was significantly reduced in cardiac patients transported with PS-HEMS compared to GEMS.
The self-video feedback method may have the potential to provide a low-cost alternative to physician-driven simulation-based training. This study aimed to assess the utility of video feedback by comparing the improvement in procedural performance when trainees received self-video feedback (trainees review their performance alone) and expert-assısted video feedback (trainees review their performance while an emergency physician provides additional feedback). This study was performed at a university simulation center with 89 final-year medical students and used a cricothyroidotomy simulation model. Following the educational presentation and the best practice video, trainees were randomized into two groups (self video-feedback and expert assisted video-feedback). They performed the cricothyroidotomy before and after the feedback, The procedures were recorded and scored. Scoring were made using a pre-defıned checklist. Mann Whitney U test and Wilcoxon test were used to analyze non-normally distributed data. For the analysis of normally distributed data, Student t-test and Paired Samples t-test were used. Results demonstrated significant improvement in cricothyroidotomy performance with both types of video feedback. The improvement was significantly greater in the expert-assisted video feedback group. We think that simulation-based training is effective with self video feedback.
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