A homemade model for training in cricothyrotomy*

Abstract

SummaryWe describe a simple, homemade model for teaching cricothyrotomy. It can easily be constructed from materials found in every anaesthetic room and is cheap, portable and usable several times before requiring replacement. We also describe evaluation of the model in a two-part study. First, 20 anaesthetic trainees, both with and without prior experience of percutaneous cricothyrotomy ⁄ tracheotomy, cannulated the 'trachea' using two percutaneous airway sets (Ravussin jet ventilation catheter, then scored the model for realism and usefulness for training. Next, 20 further trainees used the Mini-Trach II Seldinger on both the homemade model and a commercially available cricothyrotomy ⁄ tracheotomy trainer (Pharmabotics), scoring both models as before. In the first part of the study, trainees found the homemade model a useful substitute for practice of percutaneous techniques and teaching. In the second part, both models were rated well, with similar scores. The homemade model is an easily assembled alternative to more expensive models. Both experienced and inexperienced trainees find practising on such models useful.

Every Surgical Resident Should Know How to Perform a Cricothyrotomy: An Inexpensive Cricothyrotomy Task Trainer for Teaching and Assessing Surgical Trainees

“…13 Low-cost, lowfidelity simulators have been described, but they often require considerable time to build and often require animal tissues. [18][19][20] Although the benefits of low-vs high-fidelity models are unclear, low-fidelity cricothyrotomy simulation appears to be equivalent to high-fidelity simulation for learning procedural steps, whereas operator preference for realism clearly favors animal models. 13,17,21 It is not uncommon for a trainee to have the opportunity to attempt a cricothyrotomy once or twice on a cadaver or a high-fidelity model, but it is rare that they would have multiple attempts.…”

Who teaches surgical airway management and how do they teach it? A survey of United States anesthesiology training programs

“…Mannequin or cadaver training reduces cricothyrotomy time and improves the success rate in anesthesiologists and residents [26,27]. Interestingly, a simple and inexpensive model for cricothyrotomy training [28] produced skill acquisition that was comparable to a vastly more expensive human patient simulator, and both these methods of cricothyrotomy training translated effectively to human cadavers [19]. Similar to the trend in U.S. anesthesiology training programs, a combined strategy of laboratory, workshop, and human patient simulator training in Canada was recently described as a model for advanced airway management education that included infraglottic techniques (eg, cricothyrotomy, retrograde wire) [29].…”

Self-tracheotomy in acute airway obstruction: A rare case.

“…Common complications are injury to the thyroid, cricoid, posterior tracheal wall, anterior oesophageal wall, hemorrhage, and failure to provide an airway (7) . Mobility of the trachea is another important reason for failure.Consequently, the reported complication rate of emergency cricothyrotomy usually exceeds 40%, although one study reported a rate of %6 (2,8) .…”

“…Its indications are prolonged mechanical ventilation, acute upper airway obstruction, and increased secretions in the lower airways that cannot be aspirated (1) . A cricothyrotomy is a simpler surgical procedure that can be used to save patients' lives, even outside an operating room (2) .…”