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The impact of didactic read-aloud action cards on the performance of cannula cricothyroidotomy in a simulated 'can't intubate can't oxygenate' scenario.

Authors
  • Harvey, R1
  • Foulds, L2
  • Housden, T3
  • Bennett, K A4
  • Falzon, D5
  • McNarry, A F6
  • Graham, C7
  • 1 Department of Anaesthesia, Borders General Hospital, Melrose, UK.
  • 2 Department of Anaesthesia, Ninewell's Hospital, Dundee, UK.
  • 3 Department of Anaesthesia, St John's Hospital, NHS Lothian, Livingston, UK.
  • 4 Department of Anaesthesia, Wishaw General Hospital, Wishaw, UK.
  • 5 Department of Anaesthesia, Edinburgh Royal Infirmary, NHS Lothian, Edinburgh, UK.
  • 6 Departments of Anaesthesia, The Western General and St John's Hospital, NHS Lothian, Edinburgh, UK.
  • 7 Epidemiology and Statistics Core, Wellcome Trust Clinical Research Facility, University of Edinburgh, Edinburgh, UK.
Type
Published Article
Journal
Anaesthesia
Publisher
Wiley (Blackwell Publishing)
Publication Date
Mar 01, 2017
Volume
72
Issue
3
Pages
343–349
Identifiers
DOI: 10.1111/anae.13643
PMID: 27797158
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Significant benefits have been demonstrated with the use of peri-operative checklists. We assessed whether a read-aloud didactic action card would improve performance of cannula cricothyroidotomy in a simulated 'can't intubate, can't oxygenate' scenario. A 17-step action card was devised by an expert panel. Participants in their first 4 years of anaesthetic training were randomly assigned into 'no-card' or 'card' groups. Scenarios were video-recorded for analysis. Fifty-three participants (27 no-card and 26 card) completed the scenario. The number of steps omitted was mean (SD) 6.7 (2.0) in the no-card group vs. 0.3 (0.5); p < 0.001 in the card group, but the no-card group was faster to oxygenation by mean (95% CI) 35.4 (6.6-64.2) s. The Kappa statistic was 0.84 (0.73-0.95). Our study demonstrated that action cards are beneficial in achieving successful front-of-neck access using a cannula cricothyroidotomy technique. Further investigation is required to determine this tool's effectiveness in other front-of-neck access situations, and its role in teaching or clinical management. © 2016 The Association of Anaesthetists of Great Britain and Ireland.

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