A thoracoscopic cadaveric teaching model for needle decompression of a tension pneumothorax

Abstract

Introduction The purpose of this study was to evaluate the use of a cadaveric teaching model for needle compression of pneumothorax simulated by thoracoscopy. Materials and methods A standardized didactic instruction was provided to medical personnel participants at a single institution tertiary medical center. A thoracoscope was inserted into cadavers and insufflated to 20 mm Hg for simulation of a tension pneumothorax. The study participants performed six needle decompressions (3 anterior, 3 lateral), which were all directly observed thoracoscopically. Demographic data and post-surveys were obtained. The primary endpoint was participant assessment of this teaching model for a simulated pneumothorax. Secondary endpoints were successful decompression of the pneumothorax, perceived success of each attempt, and injury to intrathoracic structures. Results Forty participants completed 240 attempted decompressions. Participants reported that 43% had taken ATLS, and 63% had performed a needle decompression on a simulated patient prior to this study. The rate of successful decompressions was 85.86%. Participants reported a perceived successful completion rate of 82%. 73.7% performed this safely, while 88.5% perceived that they performed it safely. 85.7% stated that they felt more confident and capable after the study. Conclusion A simulated model is essential for adequate teaching. Our use of a thoracoscopic cadaveric model provides a realistic simulation of the pneumothorax used for training. Participants had similar rates of actual completion and perceived completion including higher rates of perceived safety. Further use of this model as a teaching tool will potentially improve the success of this life-saving procedure.