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三维打印模拟气管改善麻醉师行环甲膜切开术的技能

Three-Dimensionally Printed Simulated Tracheas to Improve Cricothyrotomy Skills Among Anesthesia Providers.

机构信息

is a staff CRNA at the University of Louisville Hospital, Louisville, Kentucky. Email:

is the Regional Technical Coordinator with Bewegen Technologies Inc., Raleigh, North Carolina.

出版信息

AANA J. 2023 Feb;91(1):23-30.

Abstract

Cricothyrotomy proficiency is imperative for anesthesia providers; however, opportunities to perform this skill are infrequent making skill maintenance essential. Increased accessibility of three-dimensional (3D) printing allows for production of low-cost simulation models. The models used for simulation-based teaching and deliberate practice facilitate skill development and refinement. A cost-effective, 3D printed airway model was designed and allowed 47 anesthesia providers to complete hands-on practice during a cricothyrotomy simulation-based training program. Assessment and comparison of pre- to post- intervention was completed for self-efficacy, knowledge, time to skill completion, compliance of required steps checklist, Global Rating Scale score, and successful ventilation. Statistically significant improvement from pre- to posttest was demonstrated in: 1) self-efficacy survey scores (P < .001); 2) knowledge test scores (P < .001); and 3) decreased time (minutes:seconds) to task completion (P < .001). Time from initial posttest to 3-month posttest (P = .046) significantly increased, however, the time at 3 months posttest remained significantly lower than pretest (P < .001). Providers' ability to ventilate, compliance with procedural steps, and technical skills significantly improved. 3D printing can produce anatomically similar simulation airway models that allow providers to practice and improve cricothyrotomy knowledge and skills. Developing an affordable and accessible simulation model provides a sustainable tool that allows providers multiple cricothyrotomy practice attempts.

摘要

环甲膜切开术的熟练程度对麻醉师来说是至关重要的;然而,进行这项技能的机会很少,因此保持技能的熟练程度是非常必要的。三维(3D)打印技术的普及使得制作低成本模拟模型成为可能。用于模拟教学和刻意练习的模型有助于技能的发展和完善。我们设计了一种具有成本效益的 3D 打印气道模型,允许 47 名麻醉师在基于环甲膜切开术模拟的培训计划中完成实际操作练习。我们对干预前后的自我效能感、知识、技能完成时间、所需步骤检查表的合规性、总体评估量表评分和通气成功率进行了评估和比较。从术前到术后测试,我们发现以下几个方面都有显著的提高:1)自我效能感调查评分(P <.001);2)知识测试评分(P <.001);3)完成任务的时间(分钟:秒)减少(P <.001)。从初始术后测试到 3 个月后的测试时间(P =.046)显著增加,但是,3 个月后的时间仍然明显低于术前(P <.001)。术者的通气能力、操作步骤的合规性和技术技能都有显著提高。3D 打印可以制作出解剖结构相似的模拟气道模型,使术者能够练习和提高环甲膜切开术的知识和技能。开发一种经济实惠且易于获取的模拟模型提供了一个可持续的工具,允许术者多次进行环甲膜切开术练习。

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