Improving Anesthesia Providers' Needle Cricothyrotomy Success With Ultrasound-Guidance: A Cadaveric Quality Improvement Project.

Difficult and failed airway management remains a significant cause of anesthesia-related morbidity and mortality. Failed airway management guidelines include performing a cricothyrotomy as a final step. Correct identification of the cricothyroid membrane (CTM) is essential for safe and accurate cric...

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Detalles Bibliográficos
Publicado en:AANA Journal Vol. 91; no. 1; pp. 15 - 22
Autor principal: Garrett, Sean G.
Formato: diagnostic images pictorial research Journal Article
Publicado: American Association of Nurse Anesthetists Feb2023
Acceso en línea:Ver este registro en EBSCOhost
Descripción
Sumario:Difficult and failed airway management remains a significant cause of anesthesia-related morbidity and mortality. Failed airway management guidelines include performing a cricothyrotomy as a final step. Correct identification of the cricothyroid membrane (CTM) is essential for safe and accurate cricothyrotomy execution. Ten certified registered nurse anesthetists were assessed for ultrasound-guided (USG) needle cricothyrotomy competency following an online and hands-on education session using a human cadaver and then assessed 60 days later, without additional education or preparation. Both knowledge and confidence improved significantly when assessed immediately after education (P < .05) and were maintained when assessed 60 days later. Overall skill performance declined slightly from post-training although the decline was not statistically significant (P = .373). Overall needle placement time and distance from the CTM improved, despite improper transducer and image orientation by most participants. A one-hour hybrid educational program can significantly improve ultrasound and cricothyrotomy knowledge and confidence for 60 days. Transducer orientation may not be a significant contributor to performing proper USG needle cricothyrotomy.