Teaching a tracheotomy handoff tool to pediatric first responders

Area of Science:

• Medical Education
• Emergency Medicine
• Airway Management

Background:

• The Critical Airway Risk Evaluation (CARE) system was developed to standardize airway risk assessment above tracheotomy tubes.
• It categorizes airways into three levels: easily intubatable, requiring specialized techniques, or not intubatable.
• Previous studies confirmed its ease of teaching and use among pediatric otolaryngologists.

Purpose of the Study:

• To assess the reliability and ease of learning the CARE system among a broader medical audience.
• To evaluate its usability by practicing otolaryngologists, otolaryngology residents, and pediatric residents.
• To determine its potential for use by first responders in tracheostomy-related emergencies.

Main Methods:

• A tutorial introducing the CARE system was provided to participants.
• A 30-point questionnaire assessed participants' ability to classify patient airways using the CARE system.
• Statistical analysis included Student's t-test and Fleiss' kappa for inter-rater reliability.

Main Results:

• 66 physicians participated, including pediatric residents, otolaryngology residents, and attending otolaryngologists.
• Pediatric residents achieved 89% accuracy, while otolaryngology specialists and residents achieved 92% accuracy.
• Inter-rater reliability was substantial across all groups, with Fleiss' kappa > 0.7.

Conclusions:

• The CARE system is effectively taught and learned by pediatric residents, mirroring the proficiency of otolaryngology trainees and specialists.
• The system's reliability supports its use in interdisciplinary handoffs.
• It can facilitate critical information transfer to first responders during airway emergencies.