TY - JOUR
T1 - A randomized cross-over study comparing surgical cricothyrotomy techniques by combat medics using a synthetic cadaver model
AU - Schauer, Steven G.
AU - Jessie, Jessie Renee
AU - L. Roper, Jamie
AU - Brown, Derek
AU - L. Jeffers, Kristine
AU - Srichandra, Jonathan
AU - Davids, Neil B.
AU - April, Michael D.
N1 - Publisher Copyright:
© 2017
PY - 2018/4
Y1 - 2018/4
N2 - Objective: Cricothyrotomy is a complex procedure with a high rate of complications including failure to cannulate and injury to adjacent anatomy. The Control-Cric™ System and QuickTrach II™ represent two novel devices designed to optimize success and minimize complications with this procedure. This study compares these two devices against a standard open surgical technique. Methods: We conducted a randomized crossover study of United States Army combat medics using a synthetic cadaver model. Participants performed a surgical cricothyrotomy using the standard open surgical technique, Control-Cric™ System, and QuickTrach II™ device in a random order. The primary outcome was time to successful cannulation. The secondary outcome was first-attempt success. We also surveyed participants after performing the procedures as to their preferences. Results: Of 70 enrolled subjects, 65 completed all study procedures. Of those that successfully cannulated, the mean times to cannulation were comparable for all three methods: standard 51.0 s (95% CI 45.2–56.8), QuickTrach II™ 39.8 s (95% CI 31.4–48.2) and the Cric-Control™ 53.6 (95% CI 45.7–61.4). Cannulation failure rates were not significantly different: standard 6.2%, QuickTrach II™ 13.9%, Cric-Control™ 18.5% (p = 0.106). First pass success rates were also similar (93.4%, 91.1%, 88.7%, respectively, p = 0.670). Of respondents completing the post-study survey, a majority (52.3%) preferred the QuickTrach II™ device. Conclusions: We identified no significant differences between the three cricothyrotomy techniques with regards to time to successful cannulation or first-pass success.
AB - Objective: Cricothyrotomy is a complex procedure with a high rate of complications including failure to cannulate and injury to adjacent anatomy. The Control-Cric™ System and QuickTrach II™ represent two novel devices designed to optimize success and minimize complications with this procedure. This study compares these two devices against a standard open surgical technique. Methods: We conducted a randomized crossover study of United States Army combat medics using a synthetic cadaver model. Participants performed a surgical cricothyrotomy using the standard open surgical technique, Control-Cric™ System, and QuickTrach II™ device in a random order. The primary outcome was time to successful cannulation. The secondary outcome was first-attempt success. We also surveyed participants after performing the procedures as to their preferences. Results: Of 70 enrolled subjects, 65 completed all study procedures. Of those that successfully cannulated, the mean times to cannulation were comparable for all three methods: standard 51.0 s (95% CI 45.2–56.8), QuickTrach II™ 39.8 s (95% CI 31.4–48.2) and the Cric-Control™ 53.6 (95% CI 45.7–61.4). Cannulation failure rates were not significantly different: standard 6.2%, QuickTrach II™ 13.9%, Cric-Control™ 18.5% (p = 0.106). First pass success rates were also similar (93.4%, 91.1%, 88.7%, respectively, p = 0.670). Of respondents completing the post-study survey, a majority (52.3%) preferred the QuickTrach II™ device. Conclusions: We identified no significant differences between the three cricothyrotomy techniques with regards to time to successful cannulation or first-pass success.
KW - Airway
KW - Cricothyrotomy
KW - Military
KW - Prehospital
KW - Surgical
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U2 - 10.1016/j.ajem.2017.11.062
DO - 10.1016/j.ajem.2017.11.062
M3 - Article
C2 - 29212602
AN - SCOPUS:85035807161
SN - 0735-6757
VL - 36
SP - 651
EP - 656
JO - American Journal of Emergency Medicine
JF - American Journal of Emergency Medicine
IS - 4
ER -