Abdelhamid Ahmed, Sapra Sadhana
Anaesthesiology, Walsall Manor Hospital, Walsall, GBR.
Cureus. 2023 Jun 6;15(6):e40040. doi: 10.7759/cureus.40040. eCollection 2023 Jun.
Background Emergency front-of-neck airway (eFONA) is a crucial life-saving procedure in "cannot intubate, cannot oxygenate" (CICO) situations. It is essential to teach and maintain eFONA skills for healthcare providers, especially anesthesiologists. This study aims to assess the effectiveness of cost-effective ovine larynx models compared to conventional manikins in teaching eFONA using the scalpel-bougie-tube technique to a group of anaesthesia novices and newly appointed anaesthetic Fellows. Methods and study design The study was conducted at Walsall Manor Hospital, a district general hospital in the Midlands, UK. Participants underwent a pre-survey to assess familiarity with FONA and the ability to perform a laryngeal handshake. After a lecture and demonstration, participants performed two consecutive emergency cricothyrotomies on both ovine models and conventional manikins, followed by a post-survey to assess their confidence in performing eFONA and rate their experience using sheep larynges. Results The training session significantly improved the participants' ability to perform a laryngeal handshake and their confidence in performing eFONA. The majority of participants rated the ovine model higher in terms of realism, difficulty with penetration, difficulty in recognising landmarks, and difficulty in performing the procedure. Additionally, the ovine model was more cost-effective compared to conventional manikins. Conclusion Ovine models provide a more realistic and cost-effective alternative to conventional manikins for teaching eFONA using the scalpel-bougie-tube technique. The use of these models in routine airway teaching enhances the practical skill set of anaesthesia novices and newly appointed anaesthetists, better preparing them for CICO situations. However, further training with objective assessment methods and larger samples is needed to corroborate these findings.
背景 紧急颈部前方气道（eFONA）是在“无法插管、无法给氧”（CICO）情况下至关重要的救命操作。对医疗保健人员，尤其是麻醉医生来说，教授并维持eFONA技能非常重要。本研究旨在评估与传统人体模型相比，具有成本效益的绵羊喉部模型在使用手术刀-探条-气管导管技术向一组麻醉新手和新任命的麻醉专科住院医生教授eFONA方面的有效性。
方法与研究设计 该研究在英国中部地区的一家区综合医院沃尔索尔庄园医院进行。参与者接受了一项预调查，以评估他们对FONA的熟悉程度和进行喉部触诊的能力。经过一次讲座和演示后，参与者在绵羊模型和传统人体模型上连续进行两次紧急环甲膜切开术，随后进行一项后调查，以评估他们进行eFONA的信心，并对使用绵羊喉部的体验进行评分。
结果 培训课程显著提高了参与者进行喉部触诊的能力以及他们进行eFONA的信心。大多数参与者认为绵羊模型在逼真度、穿刺难度、识别标志点的难度以及进行该操作的难度方面更高。此外，与传统人体模型相比，绵羊模型更具成本效益。
结论 对于使用手术刀-探条-气管导管技术教授eFONA而言，绵羊模型为传统人体模型提供了一种更逼真且具成本效益的替代方案。在常规气道教学中使用这些模型可增强麻醉新手和新任命麻醉医生的实践技能，使他们更好地为CICO情况做好准备。然而需要采用客观评估方法并以更大样本进行进一步培训，以证实这些发现。
