Crico: Simulation classique = Haute fidélité

 

A high-fidelity simulator for needle cricothyroidotomy training is not associated with increased proficiency compared with conventional simulators: A randomized controlled study.

Katayama A. et Al.  Medicine (Baltimore). 2019 Feb;98(8):e14665.

 

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L'apprentissage de la coniotomie connait un regain important depuis la publication de l'étude NAP4. Un temps oubliée, ce geste de médecine d'urgence rarement mis en oeuvre est pourtant essentiel à maîtriser non seulement dans un bloc opératoire mais aussi en préhospitalier et tout particulièrement en médecine de guerre où la fréquence des traumatismes ballistiques de la face va croissant. La simulation de ce geste est largement utilisée et des modèles sophistiqués sont proposéss. Il n'est pas certain que ces modèles relativement coûteux aient un intérêt. Un bémol doit cependant être mis. Le modèle "larynx de porc", quoique largement utilisé, ne correspond pas tout à fait à un larynx humain.

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BACKGROUND:

A high-fidelity task simulator for cricothyroidotomy was created using data from a 3-dimensional (3D) computed tomography scan using a 3D printer. We hypothesized that this high-fidelity cricothyroidotomy simulator results in increased proficiency for needle cricothyroidotomy compared with conventional simulators.

METHODS:

Cricothyroidotomy-naive residents were recruited and randomly assigned to 2 groups, including simulation training with a conventional simulator (Group C) and with a high-fidelity simulator (Group 3D). After simulation training, participants performed cricothyroidotomy using an ex vivo porcine larynx fitted with an endoscope to record the procedure. The primary outcomes were success rate and procedure time. The secondary outcome was a subjective measure of the similarity of the simulator to the porcine larynx.

RESULTS:

Fifty-two residents participated in the study (Group C: n = 27, Group 3D: n = 25). There was no significant difference in the success rate or procedure time between the 2 groups (success rate: P = .24, procedure time: P = .34). There was no significant difference in the similarity of the simulators to the porcine larynx (P = .81).

CONCLUSION:

We developed a high-fidelity simulator for cricothyroidotomy from 3D computed tomography data using a 3D printer. This anatomically high-fidelity simulator did not have any advantages compared with conventional dry simulators.