Cricothyroidotomy
Conditions
Keywords
CVCI, Emergency medicine, Airway management, Cricothyroidotomy
Brief summary
During a cannot ventilate cannot intubate situation surgical airway is the last rescue option. Especially in the prehospital setting the airway management seems to be more difficult than in a hospital setting. Nearly all emergency physicians have a limited experience with cricothyrotomy and it is a unclear what method should be taught for this lifesaving procedure, due to lack of data in humans. The aim of this study is to compare the performance of medical personnel (medical students, paramedics, trainee anaesthetists and consultants) in establishing an emergency surgical airway on a plastic laryngeal model and in a porcine laryngeal model using the Scalpel Bougie technique, the Seldinger technique and the common surgical technique. Furthermore the investigators want to elucidate whether the training of the 3 techniques has an influence in the decision making of the preferred technique in a subsequently simulated cannot ventilate cannot intubate scenario.
Detailed description
The investigators plan to recruit medical students (University Mainz), paramedics (employed in ambulance and rescue helicopter), trainee anaesthetists and consultants of the department of anesthesiology from the university hospital Mainz. After written informed consent the participants have to complete an pre-study questionnaire, than the participants get an information sheet about the 3 techniques and the investigators show the participants a short video demonstrating the different techniques. All participants have the opportunity to practice one insertion with each method on a plastic laryngeal model. After that the participants have to perform each technique on the plastic model and the investigators measure the time from initially handling equipment to the final end-point, which the investigators take as a successful placement of the endotracheal tube verified by a fiberoptic position check.
Interventions
DEVICEScalpel Bougie technique (plastic laryngeal model)
ScalpelBougie Set
DEVICESeldinger technique (plastic laryngeal model)
Melker Set
DEVICESurgical technique (plastic laryngeal model)
Scalpel and speculum
DEVICEScalpel Bougie technique (porcine laryngeal model)
ScalpelCric Set
DEVICESurgical technique (porcine laryngeal model)
Scalpel and speculum
Sponsors
Johannes Gutenberg University Mainz
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* written informed consent * German language in speaking and writing * Capability of giving consent
Exclusion criteria
* Participants unwilling or unable to give informed consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Time from initially handling equipment to a successful placement of the endotracheal tube verified by a fiberoptic position check | up to 3 minutes |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of trials | up to 3 minutes | — |
| Dimension of the tracheal trauma | up to 10 minutes | horizontally and vertically in mm |
| Success rate in the first trial | up to 3 minutes | — |
| Influence of training on the time to decision making for cricothyrotomy | up to 5 hours | After performing the different techniques of cricothyrotomy on a platistic and a porcine laryngeal model, the participants will complete a simulator training for a cannot intubate and cannot ventilate scenario. Time to decide (measured in seconds) to perform cricothyrotomy will be measured from the beginning of the scenario. |
| Influence of training on choosing the technique | up to 5 hours | After performing the different techniques of cricothyrotomy on a platistic and a porcine laryngeal model, the participants will complete a simulator training for a cannot intubate and cannot ventilate scenario. The technique (Scalpel bougie, seldinger, surgical) of cricotyrotomy, chosen by the participant will be reported and compared with the preferred technique, the participant had chosen before performing the training. |
| Comfort evaluation by the performer | up to 15 minutes | Likert-Scale: 1=very easy, 2=easy, 3=difficult, 4=very difficult |
Countries
Germany
Outcome results
None listed