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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Bibliographic Details
Published in:AANA Journal Vol. 91; no. 1; pp. 15 - 22
Main Author: Garrett, Sean G.
Format: diagnostic images pictorial research Journal Article
Published: American Association of Nurse Anesthetists Feb2023
Online Access:View this record in EBSCOhost
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      dt: Feb2023
      vid: 91
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      pub: American Association of Nurse Anesthetists
      place: Park Ridge, Illinois
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        atl: Improving Anesthesia Providers' Needle Cricothyrotomy Success With Ultrasound-Guidance: A Cadaveric Quality Improvement Project.
      aug:
        au: Garrett, Sean G.
        affil: Professor at the Middle Tennessee School of Anesthesia, Madison, Tennessee
      sug:
        subj:
          Cricothyrotomy
          Treatment Outcomes
          Airway Management Methods
          Quality Improvement
          Anesthesiologists
          Cricoid Cartilage Pathology
          Cricoid Cartilage Ultrasonography
          Needles
          Cricoid Cartilage Anatomy and Histology
          Online Education
          Ultrasonography
          Airway Obstruction Prevention and Control
          Practice Guidelines
          Certified Registered Nurse Anesthetists
          Clinical Competence
          Cadaver
          Outcomes of Education
          Nursing Knowledge
          Education, Nursing
          Confidence
          Nursing Skills
          Transducers
          Time Factors
          Algorithms
          Convenience Sample
          Surveys
          Data Analysis Software
          Descriptive Statistics
          Paired T-Tests
          Human
          Professional Competence
      ab: 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.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        research
        Journal Article
      ougenre: Article
    language: English
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