Enhancement of Cricothyroidotomy Education Using a Novel Technique: Cadaver Autografting

Ryan F. Coughlin, Iris Chandler, John C. Binford, James W. Bonz, David C. Hile

Research output: Contribution to journalArticlepeer-review

Abstract

Background Cricothyroidotomy is a lifesaving procedure required in up to 2% of emergent airways. Emergency medicine training programs frequently instruct this procedure via cadaver training, but cadaver cost and availability limit the opportunity for all trainees to perform the critical initial skin incision. Cadaver autografting is a novel way to simulate all steps of the procedure. Objective Our aim was to determine whether the technique of autografting cadaver tissue improves the experience of cricothyroidotomy simulation education for emergency medicine trainees. The investigators hypothesized that autografted cadaver tissue would be a useful adjunct. Methods In this prospective crossover study, volunteers were randomized to first perform cricothyroidotomy on previously incised native neck tissue or on autografted tissue, and then vice versa. The autograft consisted of cadaver iliotibial band covered with lateral thigh skin and subcutaneous tissue to simulate cricothyroid membrane and native anterior neck anatomy. Volunteer emergency medicine residents and sub-interns were included. Twenty-seven residents and nine students participated. Outcomes were evaluated via Likert scale. Results Thirty of 36 (83%) participants agreed or strongly agreed that they preferred cadaver autografting to the previously incised native tissue. Thirty-two of 36 (89%) agreed or strongly agreed that cadaver autografting was useful vs. 23 of 36 (64%) who answered similarly regarding previously incised native tissue (p = 0.001). Twenty-six of 36 (72%) were more comfortable with cricothyroidotomy in the emergency department after using cadaver autografting vs. 19 of 36 (53%) after using the native tissue (p = 0.003). Conclusions Autografted cadaver tissue while simulating cricothyroidotomy was perceived to be a useful adjunct by the majority of participating emergency medicine trainees.

Original languageEnglish (US)
Pages (from-to)885-889
Number of pages5
JournalJournal of Emergency Medicine
Volume53
Issue number6
DOIs
StatePublished - Dec 2017

Keywords

  • airway
  • autograft
  • cadaver
  • cricothyroidotomy
  • procedure
  • simulation

ASJC Scopus subject areas

  • Emergency Medicine

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