Postsurgical Otolaryngology Emergencies: A Simulation to Improve Multidisciplinary Patient Care During Rare, Critical...

Tracheostomy false passage and carotid blowouts are rare otolaryngologic emergencies that require rapid identification and multidisciplinary management. This multidisciplinary simulation curriculum was designed to improve technical and nontechnical skills of otolaryngology nursing and medical teams.

Multidisciplinary teams comprising nurses, medical students, and otolaryngology residents participated in 2 simulation scenarios featuring a high-fidelity mannequin, 3D-printed anterior neck, and standard airway equipment. Both cases involved a postoperative male patient (aged 50-60 years) following complex ablation and reconstruction for head and neck cancer. Scenarios simulated a carotid blowout and tracheostomy false passage (positioning outside of tracheal lumen). Participants completed pre- and postsimulation surveys, assessing self-perceived technical and nontechnical skills. Paired t tests were used to compare mean changes.

A total of 62 participants completed the simulation, the majority of whom were nurses (82%), along with medical students and otolaryngology residents, reflecting a multidisciplinary learner group. Mean nontechnical self-efficacy scores (assessing situational awareness, decision-making, communication/teamwork, and leadership) increased by 0.3 points on a 4-point scale postsimulation (P < .001). Technical self-efficacy increased by 0.5 points on a 5-point scale postsimulation (P < .001). Participants most cited improved teamwork (n = 23, 37%) and exposure to rare clinical scenarios (n = 19, 31%) as key benefits.

Carotid blowout and tracheostomy false passage simulations offer valuable exposure and practice in managing rare otolaryngology emergencies. Team-based interprofessional simulation improves technical and nontechnical self-efficacy and was positively received by participants.