Articles: thyroid-cartilage-surgery.
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Multicenter Study Observational Study
Incidence and outcomes of cricothyrotomy in the "cannot intubate, cannot oxygenate" situation.
Few data are available regarding factors that impact cricothyrotomy use and outcome in general hospital setting. The aim of the present study was to determine the incidence and outcomes of the patients underwent cricothyrotomy in a "cannot intubate, cannot oxygenate" (CICO) situation at university hospitals in Korea. This was a retrospective review of the electronic medical records of consecutive patients who underwent cricothyrotomy during a CICO situation between March, 2007, and October, 2018, at 2 university hospitals in Korea. ⋯ After failure of cricothyrotomy, various methods of securing airway were established: 3 tracheal intubations, 1 nasotracheal intubation, and 1 tracheostomy. The success rate of cricothyrotomy and survival rate in the CICO situation were not high. After failure of cricothyrotomy, various methods of securing airway were performed.
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BMC medical education · Apr 2019
Randomized Controlled Trial Multicenter StudyPerfecting practice: a protocol for assessing simulation-based mastery learning and deliberate practice versus self-guided practice for bougie-assisted cricothyroidotomy performance.
Simulation-based medical education (SBME) is a cornerstone for procedural skill training in residency education. Multiple studies have concluded that SBME is highly effective, superior to traditional clinical education, and translates to improved patient outcomes. Additionally it is widely accepted that mastery learning, which comprises deliberate practice, is essential for expert level performance for routine skills; however, given that highly structured practice is more time and resource-intensive, it is important to assess its value for the acquisition of rarely performed technical skills. The bougie-assisted cricothyroidotomy (BAC), a rarely performed, lifesaving procedure, is an ideal skill for evaluating the utility of highly structured practice as it is relevant across many acute care specialties and rare - making it unlikely for learners to have had significant previous training or clinical experience. The purpose of this study is to compare a modified mastery learning approach with deliberate practice versus self-guided practice on technical skill performance using a bougie-assisted cricothyroidotomy model. ⋯ Mastery learning coupled with deliberate practice provides systematic and focused feedback during skill acquisition. However, it is resource-intensive and its efficacy is not fully defined. This multi-centre study will provide generalizable data about the utility of highly structured practice for technical skill acquisition of a rare, lifesaving procedure within postgraduate medical education. Study findings will guide educators in the selection of an optimal training strategy, addressing both short and long term performance.
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Randomized Controlled Trial Multicenter Study
Emergency cricothyroidotomy: a randomised crossover study of four methods.
Emergency physicians and registrars performed emergency cricothyroidotomy on an artificial airway model using a standard surgical approach and three common commercial products, participants had received no refresher training. The order in which the methods were used was randomised to minimise any learning effect. ⋯ Despite success in using the surgical method, the Quicktrach and Minitrach II were rated as first or second preference by the majority of operators (78% and 70% respectively). Without refresher training emergency physicians and registrars successfully performed emergency cricothyroidotomy using the standard surgical method, Quicktrach and Minitrach II kits however the use of the Melker kit under these conditions resulted in significant delays or failure to establish an airway.
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Case Reports Multicenter Study Clinical Trial
Successful cricothyrotomy after thrombolytic therapy for acute myocardial infarction: a report of two cases.
Cricothyrotomy is an emergency airway procedure that is generally performed after failure of primary methods for securing the airway. Coagulopathy has traditionally been considered a relative contraindication to cricothyrotomy, but there is little evidence in the literature to support this. There have been no reports of successful cricothyrotomy in a patient who had received systemic thrombolytic therapy. ⋯ Intubation was impossible, and a cricothyrotomy was performed. Significant bleeding was controlled initially with packing and was semielectively explored later in the ICU with ligation of several small bleeding vessels. Prior administration of thrombolytic therapy does not preclude successful cricothyrotomy.