The introduction of emergency cricothyroidotomy simulation training in Zimbabwe contributed to the saving of two lives.
BACKGROUND
In developing countries with limited access to ENT services, performing emergency cricothyroidotomy in patients with upper airway obstruction may be a life-saving last resort. An established Danish-Zimbabwean collaboration of otorhinolaryngologists enrolled Zimbabwean doctors into a video-guided simulation training programme on emergency cricothyroidotomy. This paper presents the positive effect of this training, illustrated by two case reports.


METHODS
A 56-year-old female presented with upper airway obstruction due to a rapidly progressing infectious swelling of the head and neck progressing to cardiac arrest. Cardiopulmonary resuscitation was initiated and a secure surgical airway was established via an emergency cricothyroidotomy, saving the patient. A 70-year-old male presented with upper airway obstruction secondary to intubation for an elective procedure. When extubated, the patient exhibited severe stridor followed by respiratory arrest. Re-intubation attempts were unsuccessful and emergency cricothyroidotomy was performed to secure the airway, preserving the life of the patient.


CONCLUSIONS
Emergency cricothyroidotomy training should be considered for all surgeons, anaesthetists and, eventually, emergency and recovery room personnel in developing countries. A video-guided simulation training programme on emergency cricothyroidotomy in Zimbabwe proved its value in this regard.
Department of Otorhinolaryngology,Head and Neck Surgery and Audiology,Rigshospitalet,Copenhagen,Denmark.
M B
MB
Avnstorp
Department of Otorhinolaryngology,Head and Neck Surgery and Audiology,Rigshospitalet,Copenhagen,Denmark.
P V F
PV
Jensen
Department of Otorhinolaryngology,Parirenyatwa Hospital,Harare,Zimbabwe.
T
T
Dzongodza
Department of Otorhinolaryngology,Parirenyatwa Hospital,Harare,Zimbabwe.
N
N
Matinhira
Department of Otorhinolaryngology,Parirenyatwa Hospital,Harare,Zimbabwe.
C
C
Chidziva
Department of Otorhinolaryngology,Head and Neck Surgery and Audiology,Rigshospitalet,Copenhagen,Denmark.
J
J
Melchiors
Department of Otorhinolaryngology,Head and Neck Surgery and Audiology,Rigshospitalet,Copenhagen,Denmark.
C
C
Von Buchwald
D000368:Aged; D000402:Airway Obstruction / Q000601:surgery*; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D007821:Laryngeal Muscles / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000193:education* / Q000379:methods; D012131:Respiratory Insufficiency / Q000601:surgery*; D000066908:Simulation Training / Q000379:methods*; D015030:Zimbabwe
Airway Obstruction; Developing Countries; Emergency Cricothyroidotomy; Otorhinolaryngologic Surgical Procedures; Simulation Training; Tracheostomy