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Complex Airway Management and Decision Making In Maxillomandibular Fixation Crisis (1090-004121) (Developmental Research Projects: Procedure (By Invitation Only))
Start time: Tuesday, February 2, 2021, 3:00 PM End time: Tuesday, February 2, 2021, 4:00 PM Session Type: Research Study Development and Presentation Program Abstracts Cost: $0.00
Content Category: Researcher
Hypothesis:
A sentinel event occurred when a young male with Maxillomandibular Fixation (MMF) presented to the ED post-operatively. He began vomiting but it could not be suctioned. The anesthesia provider was unfamiliar with releasing the fixation and establishing an advanced airway in patients in MMF. The resultant prolonged severe hypoxemia and aspiration led to irreversible brain damage. A feasibility study was conducted which explored the knowledge gaps of post-operative airway management in patients in MMF. In our expansion of this pilot, we are evaluating critical decision making related to complex airway management during Maxillomandibular Fixation Crisis.
Methods:
A multi-site study evaluating providers from various specialties, including Anesthesia, Critical Care/ICU, Emergency Medicine, Emergency Medical Technicians and Paramedics. Oral Maxillofacial Surgeons (OMFS) will serve as the control group. Subjects will be randomized into the following three groups: • Group 1: sim ? didactic ? sim • Group 2: sim ? sim ? didactic • Group 3: didactic ? sim ? sim A didactic will be given instructing participants how to undo both Erich Arch Bar and Rapid Skeletal MMF and how to perform a cricothyrotomy using the Difficult Airway Algorithm and Rescue Cricothyrotomy (DAARC) curriculum. A mannequin simulator will be created with maxillary and mandibular jaws in MMF. During the in-situ simulation, participants will have to secure the airway of the mannequin patient using the technique of their choice.
Anticipated Results:
Qualitative data collected will include a pre and post-survey knowledge assessment and a structured post-simulation interview regarding the participant’s decision making in securing the airway. The simulation will be scored. Quantitative data will be collected regarding performance of tasks to test the effectiveness of the didactic. We anticipate there will be differences in decision making between various professions based on their experience with MMF and cricothyrotomy. Randomization to certain groups will likely affect decision making and performance.
Co-Presenter: Kira Nakamoto, BS, BSN, San Francisco State University About the co-presenter: Graduate nursing student from the San Francisco State University.
Disclosure: No financial relationships with ineligible companies.
Co-Presenter: Elizabeth Alexander, BA, BSN, San Francisco State University About the co-presenter: An enthusiastic and confident Registered Nurse eager to contribute to the ICU team success through hard work, attention to detail and excellent communication skills. Motivated to learn, grow and excel in critical care assessment and critical care problem-solving in order to produce positive patient outcomes.
Disclosure: No financial relationships with ineligible companies.