Schauer S, Fernandez J, Roper J, Brown D, Jeffers K, Srichandra J, Davids N, April M. A randomized cross-over study comparing surgical cricothyrotomy techniques by combat medics using a synthetic cadaver model. The American Journal of Emergency Medicine. 2018,36(4):651–656


Abstract

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.



InterNICHE keywords: syndaver

Link to journal: www.ajemjournal.com