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WHAT IS THE OPTIMAL TRAINING INTERVAL FOR A CRICOTHYROIDOTOMY (CT)?

Dept. of Anesthesiology, Toronto Western Hospital, University Health Network, University of Toronto. 2-046, Edith Cavell, 399 Bathurst Street, Toronto, ON. M5T 2S8

INTRODUCTION

A correctly performed cricothyroidotomy(CT) may be life saving in a failed airway scenario. Despite knowledge of the technique, few anesthesiologists have the practical skills to perform a CT correctly and expediently. The purpose of our study was to compare the effect of training intervals on time to achieve a successful CT.

METHODS

Following hospital ethics approval, 22 anesthesiologists were instructed by a 3 min video and asked to perform a dilatational CT using a pre-assembled Melker CT set (#4 ID, Cook Inc) on a manikin. The number of attempts and the time taken for each attempt (from skin palpation to lung inflation) were recorded until a successful CT was performed in less than 40 sec. This 40 sec limit was determined arbitrarily by a consensus panel. Participants were randomised into 2 groups of 11. Group 1 was reassessed after 30 days and group 2, 90 days. Statistical analysis was done using Student T test for the time achieved on the first CT, Mann Whitney U Test for the number of attempts and Fisher's Exact Test for the number of anesthesiologists successful on the first attempt. P<0.05 was considered statistically significant.

RESULTS

Demographics of age, position, number of years in practice and previous CT experience were similar between the groups.

DISCUSSION

Performance of CT improved at a 30 day retraining interval (Group1) while it did not at a 90 day interval (Group2). Our results suggest that a 30 day retraining interval may be more appropriate than 90 day for maintaining CT skills.

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