Impact of simulation-based training on bougie-assisted cricothyrotomy technique: a quasi-experimental study

Abstract

Background: Cricothyrotomy is a lifesaving surgical technique in critical airway events. However, a large proportion of anesthesiologists have little experience with cricothyrotomy due to its low incidence. This study aimed to develop a multisensory, readily available training curriculum for learning cricothyrotomy and evaluate its training effectiveness. Methods: Seventy board-certificated anesthesiologists were recruited into the study. Participants first viewed an instructional video and observed an expert performing the bougie-assisted cricothyrotomy on a self-made simulator. They were tested before and after a one-hour practice on their cricothyrotomy skills and evaluated by a checklist and a global rating scale (GRS). Additionally, a questionnaire survey regarding participants’ confidence in performing cricothyrotomy was conducted during the training session. Results: The duration to complete cricothyrotomy was decreased from the pretest (median = 85.0 s, IQR = 72.5–103.0 s) to the posttest (median = 59.0 s, IQR = 49.0–69.0 s). Furthermore, the median checklist score was increased significantly from the pretest (median = 30.0, IQR = 27.0-33.5) to the posttest (median = 37.0, IQR = 35.5–39.0), as well as the GRS score (pretest median = 22.5, IQR = 18.0–25.0, posttest median = 32.0, IQR = 31.0-33.5). Participants’ confidence levels in performing cricothyrotomy also improved after the curriculum. Conclusion: The simulation-based training with a self-made simulator is effective for teaching anesthesiologists to perform cricothyrotomy.