Training in En-route Cricothyroidotomy: Skill Durability at 6 Month Follow Up (1090-003519) (Award Winning Abstract)
Start time: Tuesday, January 19, 2021, 1:00 PM End time: Tuesday, January 19, 2021, 2:00 PM Session Type: Research Abstracts (Completed Studies)
Airway obstruction ranks third as a preventable cause of death on the battlefield and accounts for 1-2% of total combat fatalities. Therefore, one of the vital skills that must be mastered by combat first responders is the ability to recognize the need for and perform a surgical cricothyroidotomy (SC). We had previously reported results on training 89 novices on how to perform a SC to expert level in a helicopter en-route care environment. The purpose of this study is to assess the durability of this skill in a cohort of participants six months after initial training in the same environment.
A random sample of 22 subjects (15 first year medical students and 7 hospital corpsmen) who previously underwent SC training were selected to return at 6 months after training to re-test in the same helicopter scenario. Participants did not receive any refresher training between initial training and follow-up testing. All attempts were captured via head mounted video recordings and graded by blinded evaluators using the same 10 item standardized checklist used in initial training. Our previous work found that expert criteria for performing a SC was = 40 seconds and completion of 9/10 items on the checklist. Outcome measures in this study were time to complete the procedure and percent of subjects who completed at least 9/10 items on the checklist.
Twenty two subjects were re-tested at six months. Eight out of 22 (36.4%) participants met expert criteria for an en-route SC on their first attempt. Two additional subjects met expert criteria after a second attempt. There was a significant increase in time required to complete the procedure compared to initial training (x¯ 46.4 +/- 29.8 sec vs. 25.4 +/- 3.2 sec; p < 0.05, and a significant decrease in checklist scores on the 6 month follow up testing (x¯ 9.8 +/- 0.4 vs. 7.8 +/- 1.5; p < 0.05). There was no significant differences in mean decay between medical students and corpsmen
This study showed that the skill required to perform a surgical cricothyroidotomy after initial training and practice does decay significantly and may lead to negative outcomes. Next steps are to consider the structure of a brief retraining curriculum for the sustainment of SC skills to maintain competence in this life saving procedure.
Co-Presenter: Laura Kraemer, BS, Uniformed Services University of the Health Sciences About the co-presenter: Currently a medical student at the Uniformed Services University of the Health Sciences. Undergraduate completed at California Polytechnic State University, San Luis Obispo with a double major in Microbiology and Biological Sciences with an emphasis in cellular and molecular biology. Performed a two year research post undergraduate fellowship at the National Institutes of Health in Inflammation Immunology under the Laboratory of Allergic Disease.
Disclosure: No financial relationships with ineligible companies.