• Interact Cardiovasc Thorac Surg · Feb 2015

    Randomized Controlled Trial Comparative Study

    A home-made animal model in comparison with a standard manikin for teaching percutaneous dilatational tracheostomy.

    • Alfonso Fiorelli, Emanuele Carelli, Denise Angioletti, Annarita Orsini, Anna D'Elia, Annarita Torino, Mario Santini, and Fausto Ferraro.
    • Thoracic Surgery Unit, Second University of Naples, Naples, Italy.
    • Interact Cardiovasc Thorac Surg. 2015 Feb 1;20(2):248-53.

    ObjectivesAs airway management specialists, thoracic surgeons should be familiar with percutaneous dilatational tracheostomy. To optimize the learning curve, we propose a home-made pig model obtained from a slaughterhouse for training residents in the technical aspects of performing percutaneous dilatational tracheostomy. The satisfaction of the residents' training experience using this model was compared with that using a standard manikin model.MethodsFifty residents participated in the present study. At the end of the session, each participant completed a questionnaire assessing the pig model and the manikin by assigning a score (ranging from 1 to 4) to five specific characteristics including (i) reality of skin turgor; (ii) landmark recognition; (iii) feasibility of the procedure; (iv) reality of the model and (v) preference of each model. The differences between models were statistically analysed.ResultsForty-five participants completed the study. The pig model, compared with the manikin model, presented a higher value regarding the reality of skin turgor (1.7 ± 0.5 vs 0.4 ± 0.8; respectively, P < 0.0001); landmark recognition (3.8 ± 0.5 vs 2.0 ± 0.5; respectively; P < 0.0001) and reality of the model (3.0 ± 0.8 vs 1.3 ± 1.0; respectively; P < 0.0001). No difference was found regarding the feasibility of the procedure (3.7 ± 0.6 vs 3.5 ± 0.5; respectively, P = 0.1). The pig model was preferred to the manikin (3.2 ± 0.7 vs 1.6 ± 1.0; respectively, P < 0.0001).ConclusionsOur pig model allowed residents to develop the skills required for successful percutaneous dilatational tracheostomy. In particular, they developed confidence with certain manoeuvres such as needle and guide-wire placement, dilatation of the trachea and insertion of a cannula, before attempting the procedure on a live patient.© The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

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