title: Every surgical resident should know how to perform a cricothyrotomy: an inexpensive cricothyrotomy task trainer for teaching and assessing surgical trainees.
abstract: OBJECTIVE
  Emergency cricothyrotomy is a rare but potentially lifesaving procedure. Training opportunities for surgical residents to learn this skill are limited, and many graduating residents have never performed one during their training. We aimed to develop and validate a novel and inexpensive cricothyrotomy task trainer that can be constructed from household items.
  
  
  METHODS
  A model was constructed using a toilet paper roll (trachea and larynx), Styrofoam (soft tissue), cardboard (thyroid cartilage), zip tie (cricoid), and fabric (skin). Participants were asked to complete a simulated cricothyrotomy procedure using the model. They were then evaluated using a 10-point checklist (5 points total) devised by 6 general surgeons. Participants were also asked to complete an anonymous survey rating the educational value and the degree of enjoyment regarding the model.
  
  
  METHODS
  A tertiary care teaching hospital.
  
  
  METHODS
  A total of 54 students and general surgery residents (11 medical students, 32 interns, and 11 postgraduate year 3 residents).
  
  
  RESULTS
  All 54 participants completed the training and assessment. The scores ranged from 0 to 5. The mean (range) scores were 1.8 (1-4) for medical students, 3.5 (1-5) for junior residents, and 4.9 (4-5) for senior-level residents. Medical students were significantly outperformed by junior- and senior-level residents (p < 0.001). Trainees felt that the model was educational (4.5) and enjoyable (4.0).
  
  
  CONCLUSIONS
  A low-fidelity, low-cost cricothyrotomy simulator distinguished the performance of emergency cricothyrotomy between medical students and junior- and senior-level general surgery residents. This task trainer may be ideally suited to providing basic skills to all physicians in training, especially in settings with limited resources and clinical opportunities.
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Johnathon M
authors.initials: JM
authors.lastname: Aho
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Cornelius A
authors.initials: CA
authors.lastname: Thiels
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Yazan N
authors.initials: YN
authors.lastname: AlJamal
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Raaj K
authors.initials: RK
authors.lastname: Ruparel
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Phillip G
authors.initials: PG
authors.lastname: Rowse
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Stephanie F
authors.initials: SF
authors.lastname: Heller
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, Minnesota. Electronic address: farley.david@mayo.edu.
authors.forename: David R
authors.initials: DR
authors.lastname: Farley
mesh_terms: D000402:Airway Obstruction / Q000601:surgery*; D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000379:methods*; D004635:Emergency Medicine / Q000193:education*; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D007830:Larynx / Q000601:surgery*; D000066908:Simulation Training
keywords: Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; cricothyrotomy; emergency airway; low cost; simulation