Emergent Cricothyrotomy: Multiple Professions Feedback on Challenges of Maintaining Competency
Bibliographic record
Abstract
Background: In critical cannot intubate cannot oxygenate situations, cricothyrotomies are an option for an emergent airway; however, many people practice for years without performing or assisting with one. This survey set out to discover what equipment and education would enable familiarity and competency with performing/assisting with this procedure based on experience. Methods: Interior Health comprises community to tertiary hospitals. 62 individuals within IH responded to an 18-question survey: 3% anesthesia assistant (AA), 7% anesthesiologist, 24% emergency physician, 2% ENT physician, 14% internist/intensivist, and 50% RT. Representation was from a wide spectrum of career experience: 15% 0-2 years, 11% 3-5 years, 36% 6-10 years, 19% 11-20 years, and 19% greater than 20 years. IH Privacy Impact department and ARECCI IRB approved this survey. Results: 75% of the physicians, RTs, and AAs felt that scalpel bougie procedure is the easiest method of performing a cricothyrotomy to maintain competency. Currently only 70% of RTs and AAs agree or strongly agree they are familiar with their role during an emergent cricothyrotomy and 53% agree or strongly agree they are competent assisting. 65% of all participants stated that their workplace had more than one type of emergent cricothyrotomy kit and 30% strongly disagreed, disagreed, or were neutral to being familiar with emergent cricothyrotomy equipment at their hospital. 69% of participants were agreeable to having only one emergent cricothyrotomy procedure and set of equipment even if this meant it was not their preferred method. 61% of participants have never performed or assisted with an emergent cricothyrotomy. 52% of participants would like hands-on cricothyrotomy education simulations every year. Conclusions: Standardization of equipment and procedure may improve competency but there is some initial opposition to this option. Best success for positive patient outcomes as well as ease of performing and assisting is by using the scalpel bougie method. Yearly hands-on education is desired for familiarity and competency with the cricothyrotomy procedure as this study revealed that many participants of this survey have not yet had to perform/assist with this skill throughout their career, and those that have, have done so quite infrequently. This provides us with an opportunity to develop multidisciplinary education/simulation days to support overall success for both patients and the professionals involved in emergent cricothyrotomies.Maintaining Cricothyrotomy Competency AgreeNeutralDisagreeIt would be easier to maintain competency if there was only one type of emergent cricothyrotomy equipment N=6268%RT & AA =70%Physician=66%22%RT & AA =21%Physician=24%10%RT & AA=9%Physician=10%Would you be agreeable to having only one emergent cricothyrotomy procedure and set of equipment even if this meant it was not your preferred method of emergent cricothyrotomy? N=6169%RT & AA=85%Physician=50%N/A31%RT & AA=15%Physician=50%Virtual education is equivalent to hands on education with emergent cricothyrotomy N=623%RT & AA=6%Physician =0%16%RT & AA=12%Physician=21%81%RT & AA =82%Physician=79%Methods of Performing Emergent Cricothyrotomy SCALPEL BOUGIESURGICAL CRICOTHYROTOMY TRAYPRE-MANUFACTURED KITUNCERTAINWhich method of performing an emergent cricothyrotomy do you feel has the greatest evidence for improved patient outcomes? N=6257%RT & AA=67%Physician=41%3%RT & AA=0%Physician=7%10%RT & AA=9%Physician=14%30%RT &AA=24Physician=38%Which method of performing an emergent cricothyrotomy do you feel is the easiest for your profession to maintain competency? N=6176%RT & AA=88%Physician=61%3%RT & AA=0%Physician=7%21%RT & AA=12%Physician=32%0%RT & AA=0%Physician=0%
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".