Difficult airway simulation-based training for anaesthesiologists: efficacy and skills retention within six months
Abstract Background The aim of this study was to evaluate how anaesthesiologists manage a “cannot intubate, can ventilate” (CI) and “cannot intubate, cannot ventilate” (CICV) scenarios, and how following simulation training will affect their guideline adherence, skills and decision-making immediatel...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-01-01
|
| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12871-024-02423-x |
| _version_ | 1827326421409726464 |
|---|---|
| author | Kateryna Bielka Iurii Kuchyn Hanna Fomina Olena Khomenko Iryna Kyselova Michael Frank |
| author_facet | Kateryna Bielka Iurii Kuchyn Hanna Fomina Olena Khomenko Iryna Kyselova Michael Frank |
| author_sort | Kateryna Bielka |
| collection | DOAJ |
| description | Abstract Background The aim of this study was to evaluate how anaesthesiologists manage a “cannot intubate, can ventilate” (CI) and “cannot intubate, cannot ventilate” (CICV) scenarios, and how following simulation training will affect their guideline adherence, skills and decision-making immediately after training and 6 months later. Methods A prospective controlled study was conducted from July to December 2022. Anaesthesiologists who applied for the continuous medical education course “Difficult Airway Management” were involved in the study. Each volunteer participated in two simulation scenarios (CI, CICV) with structural debriefing after each scenario. After the first simulation round, volunteers were trained in difficult airway management according to DAS guidelines, using the same equipment as during the simulation. The participants repeated the simulation scenarios the day after the training and six months later. The primary and secondary endpoints were compared between three rounds: initial simulation (Group 1), immediately after training (Group 2), and six months after training (Group 3). Results A total of 24 anaesthesiologists consented to participate in the study and completed the initial survey form. During the first session, 83.3% of participants had at least one major deviation from the DAS protocol. During the first CICV scenario, 79% of participants made at least one deviation from the DAS protocol. The second time after simulation training, significantly better results were achieved: the number of anaesthesiologists, who attempted more than 3 laryngoscopies decreased (OR = 7 [1.8–26.8], p = 0.006 right after training and OR = 3.9 [1.06–14.4], p = 0.035 6 month later); the number, who skipped the supralaryngeal device attempt, call for help and failure to initiate surgical airway also decreased. Simulation training also significantly decreases the time to call for help, cricothyroidotomy initiation time, and mean desaturation time and increases the odds ratio of successful cricothyroidotomy (OR 0.02 [0.003–0.14], p < 0.0001 right after training and OR = OR 0.02 [0.003–0.16] 6 months after training). Conclusions Anaesthesiologists usually display major deviations from DAS guidelines while managing CI and CICV scenarios. Simulation training improves their guideline adherence, skills, and decision-making when repeating the simulation immediately after training and 6 months later. Study registration NCT05913492, clinicaltrials.gov, 22/06/2023. |
| first_indexed | 2024-03-07T14:44:15Z |
| format | Article |
| id | doaj.art-045266082c6b424890ce7526fe3f3e31 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-03-07T14:44:15Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-045266082c6b424890ce7526fe3f3e312024-03-05T20:04:46ZengBMCBMC Anesthesiology1471-22532024-01-012411710.1186/s12871-024-02423-xDifficult airway simulation-based training for anaesthesiologists: efficacy and skills retention within six monthsKateryna Bielka0Iurii Kuchyn1Hanna Fomina2Olena Khomenko3Iryna Kyselova4Michael Frank5Postgraduate department of Surgery, Anaesthesiology and Intensive Care, Bogomolets National Medical UniversityPostgraduate department of Surgery, Anaesthesiology and Intensive Care, Bogomolets National Medical UniversityPostgraduate department of Surgery, Anaesthesiology and Intensive Care, Bogomolets National Medical UniversityPostgraduate department of Surgery, Anaesthesiology and Intensive Care, Bogomolets National Medical UniversityPostgraduate department of Surgery, Anaesthesiology and Intensive Care, Bogomolets National Medical UniversityPostgraduate department of Surgery, Anaesthesiology and Intensive Care, Bogomolets National Medical UniversityAbstract Background The aim of this study was to evaluate how anaesthesiologists manage a “cannot intubate, can ventilate” (CI) and “cannot intubate, cannot ventilate” (CICV) scenarios, and how following simulation training will affect their guideline adherence, skills and decision-making immediately after training and 6 months later. Methods A prospective controlled study was conducted from July to December 2022. Anaesthesiologists who applied for the continuous medical education course “Difficult Airway Management” were involved in the study. Each volunteer participated in two simulation scenarios (CI, CICV) with structural debriefing after each scenario. After the first simulation round, volunteers were trained in difficult airway management according to DAS guidelines, using the same equipment as during the simulation. The participants repeated the simulation scenarios the day after the training and six months later. The primary and secondary endpoints were compared between three rounds: initial simulation (Group 1), immediately after training (Group 2), and six months after training (Group 3). Results A total of 24 anaesthesiologists consented to participate in the study and completed the initial survey form. During the first session, 83.3% of participants had at least one major deviation from the DAS protocol. During the first CICV scenario, 79% of participants made at least one deviation from the DAS protocol. The second time after simulation training, significantly better results were achieved: the number of anaesthesiologists, who attempted more than 3 laryngoscopies decreased (OR = 7 [1.8–26.8], p = 0.006 right after training and OR = 3.9 [1.06–14.4], p = 0.035 6 month later); the number, who skipped the supralaryngeal device attempt, call for help and failure to initiate surgical airway also decreased. Simulation training also significantly decreases the time to call for help, cricothyroidotomy initiation time, and mean desaturation time and increases the odds ratio of successful cricothyroidotomy (OR 0.02 [0.003–0.14], p < 0.0001 right after training and OR = OR 0.02 [0.003–0.16] 6 months after training). Conclusions Anaesthesiologists usually display major deviations from DAS guidelines while managing CI and CICV scenarios. Simulation training improves their guideline adherence, skills, and decision-making when repeating the simulation immediately after training and 6 months later. Study registration NCT05913492, clinicaltrials.gov, 22/06/2023.https://doi.org/10.1186/s12871-024-02423-xSimulationDifficult airwaysIntubation |
| spellingShingle | Kateryna Bielka Iurii Kuchyn Hanna Fomina Olena Khomenko Iryna Kyselova Michael Frank Difficult airway simulation-based training for anaesthesiologists: efficacy and skills retention within six months BMC Anesthesiology Simulation Difficult airways Intubation |
| title | Difficult airway simulation-based training for anaesthesiologists: efficacy and skills retention within six months |
| title_full | Difficult airway simulation-based training for anaesthesiologists: efficacy and skills retention within six months |
| title_fullStr | Difficult airway simulation-based training for anaesthesiologists: efficacy and skills retention within six months |
| title_full_unstemmed | Difficult airway simulation-based training for anaesthesiologists: efficacy and skills retention within six months |
| title_short | Difficult airway simulation-based training for anaesthesiologists: efficacy and skills retention within six months |
| title_sort | difficult airway simulation based training for anaesthesiologists efficacy and skills retention within six months |
| topic | Simulation Difficult airways Intubation |
| url | https://doi.org/10.1186/s12871-024-02423-x |
| work_keys_str_mv | AT katerynabielka difficultairwaysimulationbasedtrainingforanaesthesiologistsefficacyandskillsretentionwithinsixmonths AT iuriikuchyn difficultairwaysimulationbasedtrainingforanaesthesiologistsefficacyandskillsretentionwithinsixmonths AT hannafomina difficultairwaysimulationbasedtrainingforanaesthesiologistsefficacyandskillsretentionwithinsixmonths AT olenakhomenko difficultairwaysimulationbasedtrainingforanaesthesiologistsefficacyandskillsretentionwithinsixmonths AT irynakyselova difficultairwaysimulationbasedtrainingforanaesthesiologistsefficacyandskillsretentionwithinsixmonths AT michaelfrank difficultairwaysimulationbasedtrainingforanaesthesiologistsefficacyandskillsretentionwithinsixmonths |