Data from: Cadaveric emergency cricothyrotomy training for non-surgeons using a bronchoscopy-enhanced curriculum

Emergency cricothyrotomy training for non-surgeons providing critical care
is important as rare “cannot intubate or oxygenate events” may occur
multiple times in a provider’s career when surgical expertise is not
immediately available. However, such training is highly variable and often
infrequent so enhancing these experiences is important. Our study was
performed after implementing a program to train non-surgeon providers on
cadaveric donors. Standard training with an instructional video and live
coaching was enhanced by bronchoscopic visualization of the trachea
allowing participants to review their technique after performing scalpel
and Seldinger-technique procedures, and to review their colleagues’
technique on live video. Feasibility was measured through assessing
helpfulness for trainees, cost, setup time, quality of images, and
operator needs. Footage from the bronchoscopy recordings was analyzed to
assess puncture-to-tube time and errors. Participants submitted pre- and
post-session surveys assessing their levels of experience and gauging
their confidence and anxiety with cricothyrotomies. We found our training
program met feasibility criteria for low costs, setup time, and operator
needs. Furthermore, all 24 participants rated the cadaveric session as
helpful and demonstrated efficient technique by puncture-to-tube times.
Bronchoscopy videos revealed that sharp instrument puncturing of the
posterior tracheal wall was common and that improper tube placement
occurred but was uncommon. Bronchoscopic enhancement was rated as quite or
extremely helpful for visualizing the trachea and to assess depth of
instrumentation. There was a significant increase in confidence and
decrease in performance anxiety after the session. Our findings confirm
that supplementing cadaveric emergent cricothyrotomy training programs
with tracheal bronchoscopy is feasible, helpful to trainees, meets prior
documented times for efficient technique, and detects technical errors
that would have been missed in a standard training program. Bronchoscopic
enhancement is a valuable addition to cricothyrotomy cadaveric training
programs and may help avoid real-life complications.