Improving Anesthesia Providers' Needle Cricothyrotomy Success With Ultrasound-Guidance: A Cadave Quality Improvement Project.

Difficult and failed airway management remains a significant cause of anesthesia-related morbidity and mortality. Failed airway management guidelines include performing a cricothyrotomy as a final step. Correct identification of the cricothyroid membrane (CTM) is essential for safe and accurate cricothyrotomy execution. Ten certified registered nurse anesthetists were assessed for ultrasound-guided (USG) needle cricothyrotomy competency following an online and hands-on education session using a human cadaver and then assessed 60 days later, without additional education or preparation. Both knowledge and confidence improved significantly when assessed immediately after education (P < .05) and were maintained when assessed 60 days later. Overall skill performance declined slightly from post-training although the decline was not statistically significant (P = .373). Overall needle placement time and distance from the CTM improved, despite improper transducer and image orientation by most participants. A one-hour hybrid educational program can significantly improve ultrasound and cricothyrotomy knowledge and confidence for 60 days. Transducer orientation may not be a significant contributor to performing proper USG needle cricothyrotomy.

Virtual Simulation to Reinforce Nursing Staff Resuscitation Responses.

In-hospital cardiac arrests have high mortality rates, increased by delayed resuscitation. Using a single group pre-post interventional design to implement virtual cardiac arrest simulations for medical-surgical units, the purpose of this project was to decrease resuscitation delays and improve self-confidence of the nursing staff. Both response times and confidence improved following virtual simulation. Conducting virtual simulation for resuscitation training may be a valuable alternative to in situ simulation.