Three-dimensional printed model for cricothyroidotomy training
Fontana J, Coursen J, Hrabec D, and Krupp SS. Three-dimensional printed model for cricothyroidotomy training. Academic Emergency Medicine 2020; 27:S334.
Academic emergency medicine
Intro/Background: Each year second year emergency medicine residents complete a 'Difficult Airway Course' as part of their medical training. This involves performing surgical cricothyrotomy on pig tracheas which poorly resemble human subjects and are costly.
Purpose/Objective: In an effort to improve proficiency and training for a potentially life saving emergency procedure, a 3D printed model of a human trachea was compared to that of a pig trachea to evaluate proficiency, user acceptance, and cost-comparison to that of the standard pig tracheas among second year emergency residents. It is anticipated that this will potentially provide safer patient care by emergency physicians at a lower price.
Methods: Residents were divided into two groups - Group 1 performing pig trachea followed by 3D model and Group 2 performing 3D model followed by pig trachea. Data was collected using pre and post procedure questionnaire's and recording time to successful cricothyrotomy. Overall user acceptance with regards to resemblance of human trachea, number of attempts, and time to successful cricothyrotomy were compared between Group 1 and Group 2.
Outcomes: Difference in time between 3D and Pig model was 34.9 ±31 sec, 95% CI -3.0 to 72.9, p=0.07 (meaning the 3D model took an additional 34.9 sec on average). Clinicians rated the resemblance higher for the 3D model, mean difference 0.62 (95% CI 0.22 - 1.01), p=0.005.
Summary: Cricothyrotomy is a rare but lifesaving procedure that must be taught to emergency medicine residents. Current methods rely on pig trachea models to simulate this procedure. We have developed a 3D printed model as an alternative for simulation. There was a statistically significant higher resemblance of the 3D model versus the standard pig model when compared to the human trachea. The longer procedure times recorded for the 3D model may reflect the procedural complexity inherit to cricothyrotomies. Future studies of this life saving procedure can be validated and compared to that of more experienced physicians and their respective skillset when it comes to cricothyrotomies. The ability to reuse the 3D printed model will provide longevity and consistent training among residents at a lower price point. This 3D model can be demonstrated at a table top demonstration at SAEM.