Simulation-based airway management curriculum is superior to no intervention and nonsimulation intervention for important education outcomes. Further research is required to fine-tune optimal curricular design.
Cricoid pressure (CP) is commonly applied during rapid sequence intubation and may be protective during induction of anaesthesia; however, CP application by untrained practitioners may not be performed optimally. The objective of this systematic review was to synthesize the evidence regarding effectiveness of technology-enhanced simulation training to improve efficacy of CP application. Electronic databases from inception through May 11, 2011 were searched. Eligible studies evaluated CP simulation training. Independent reviewers working in duplicate extracted study characteristics, validity, and outcomes data. Pooled effect size (ES) with 95% confidence intervals (CIs) were estimated from each study that compared technology-enhanced simulation with no intervention or with other methods of CP training using random-effects model. Twelve studies (772 trainees) evaluated CP training as an outcome. Nine studies reported information on baseline skill, with 23% of providers being able to achieve the target CP before training. In a meta-analysis of 10 studies (570 trainees), CP training resulted in a large favourable impact on skills among trainees compared with no intervention (pooled ES 1.18; 95% CI 0.85-1.51; P<0.0001). Four studies found evidence of skills retention for CP application after training, but for a limited time (<4 weeks). Comparative effectiveness research shows beneficial effects to force feedback training over training without feedback. Simulation training significantly improves the efficacy of CP application. Future studies might evaluate the clinical impact of training on CP application during rapid sequence intubation, and the comparative effectiveness of different training approaches.
12%). For traceable partners (73% of men's; 88% of women's), 9/157 men's partners and 16/114 women's partners required provider-led PN. Almost all were casual or ex-partners (8/9 men's; 13/16 women's). NNTITs were lowest for ex-partners: 0.6 and 0.45 for men and women, respectively, followed by casual partners: 0.8 and 0.6, then regular partners: 1.80 and 0.9. Discussion Provider-led PN is required more often with casual and ex-partners than with regular partners. This may have greater cost implications for services, but, as casual and ex-partners are likely to have greater numbers of partners themselves, the potential for preventing onward transmission is greater, yielding greater public health benefit. Services should collect data from their index patients on the number and type(s) of partners, as well as the PN method(s) required (patient vs provider referral). Together with cost data, these data were key for demonstrating the cost-benefit of provider-led PN.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.