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The introduction of emergency cricothyroidotomy simulation training in Zimbabwe contributed to the saving of two lives

Published online by Cambridge University Press:  09 September 2016

M B Avnstorp ,
P V F Jensen ,
T Dzongodza ,
N Matinhira ,
C Chidziva ,
J Melchiors  and
C Von Buchwald
M B Avnstorp*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
P V F Jensen
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
T Dzongodza
Affiliation:
Department of Otorhinolaryngology, Parirenyatwa Hospital, Harare, Zimbabwe
N Matinhira
Affiliation:
Department of Otorhinolaryngology, Parirenyatwa Hospital, Harare, Zimbabwe
C Chidziva
Affiliation:
Department of Otorhinolaryngology, Parirenyatwa Hospital, Harare, Zimbabwe
J Melchiors
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark Copenhagen Academy of Medical Simulation and Education, Rigshospitalet, Denmark
C Von Buchwald
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
*
Address for correspondence: Dr Magnus Balslev Avnstorp, Dept of Otorhinolaryngology, Head and Neck Surgery and Audiology, F2071, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark. E-mail: [email protected]
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Abstract

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.

Case reports:

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.

Conclusion:

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.

Keywords

Airway ObstructionDeveloping CountriesOtorhinolaryngologic Surgical ProceduresEmergency CricothyroidotomyTracheostomySimulation Training
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 10 , October 2016 , pp. 923 - 927
Copyright
Copyright © JLO (1984) Limited 2016 

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