ArticleBMC anesthesiology2017
Determining the amount of training needed for competency of anesthesia trainees in ultrasonographic identification of the cricothyroid membrane.
Article in BMC anesthesiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04482166 (Learning Curve of Fiberoptic-guided Tracheal Intubation Through Supraglottic Airway Device for Pediatric Difficult Airway Manikin), which is not on this map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Learning Curve of Fiberoptic-guided Tracheal Intubation Through Supraglottic Airway Device for Pediatric Difficult Airway Manikin
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Point-of-care ultrasound of the upper airway in difficult airway management: a systematic review and meta-analysis.Anaesthesia · 2025Pooled it
- Training for pediatric cannot intubate cannot oxygenate: surgical airway should replace needle cricothyrotomy.Frontiers in disaster and emergency medicine · 2026Article
- Paramedics Performed Sonographic Identification of the Conic Ligament-A Prospective Controlled Trial.Diagnostics (Basel, Switzerland) · 2025Article
- Assessment of pre-extubating recurrent laryngeal nerve palsy using ultrasound in postoperative patients with esophageal cancer: a prospective observational study.Journal of anesthesia · 2024Observational
- Point-of-care ultrasound for airway management in the emergency and critical care setting.Clinical and experimental emergency medicine · 2024Article
- Application of Machine Learning to Ultrasonography in Identifying Anatomical Landmarks for Cricothyroidotomy Among Female Adults: A Multi-center Prospective Observational Study.Journal of imaging informatics in medicine · 2024Article
- Teaching approaches and satisfaction of medical students during anesthesia rotations: a multicenter cross-sectional study.BMC medical education · 2023Observational
- Objective structured assessment ultrasound skill scale for hyomental distance competence - psychometric study.BMC medical education · 2023Article
- A learning curve of a novel multimodal endotracheal intubation assistant device for novices in a simulated airway: a prospective manikin trial with cumulative sum method.Translational pediatrics · 2022Article
- Competency Assessment in Focused Cardiac Ultrasound-Can the Use of Sequential Testing Help Tailor Training Requirements?Critical care explorations · 2022Article
- Ultrasonographic identification of the cricothyroid membrane in a patient with a difficult airway as a result of cervical hematoma caused by hemophilia: a case report.BMC anesthesiology · 2019Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAirway guidelines recommend the use of ultrasound to localize the cricothyroid membrane prior to airway manipulation in difficult airways. In this study, we aimed to determine the amount of training anesthesia trainees would need to achieve competence in bedside ultrasound to identify the cricothyroid membrane.
methodsThis is a prospective non-randomized cohort study in the Department of Anesthesia at Mount Sinai Hospital (Toronto, Ontario, Canada). Following institutional ethics approval, six anesthesia trainees consisting of four residents and two fellows underwent a 2-h training session on neck ultrasound to identify neck landmarks and the cricothyroid membrane. The trainees had no previous airway ultrasound experience. One-two weeks later, each trainee performed consecutive neck ultrasound scans on 20 healthy volunteers to identify the cricothyroid membrane. Cumulative sum (CUSUM) learning curves were constructed for each trainee. Primary outcome was the number of ultrasound examinations required to achieve competence, defined as 90% success rate in a series of 20 ultrasound scans. Secondary outcomes were the overall success rate, the time (sec.) required to perform the task, and 3-month skills assessment.
resultsCUSUM analysis showed four trainees achieved competence with a mean [range] success rate of 94.0% [90-100%] and a median [range] number of attempts of 14 [9-18]. Two trainees did not achieve competence, but obtained a success rate of 75.0 and 80.0% each. Overall (number of attempts) success rate was 88.3% (106/120) with a mean (SD) time of 36.9 (9.0) sec. Three months after training, ultrasound of five consecutive neck scans showed a mean success rate of 86.7% (26/30) and mean (SD) time of 47.7 (16.0) sec.
conclusionsAfter a short 2-h training session, most anesthesia trainees (n = 4/6) achieved competence in ultrasound-identification of the cricothyroid membrane with less than 20 scans in a mean time less than 60 s., and that they remain reasonably competent 3 months later. The learning curve for ultrasound identification of the cricothyroid membrane seems to be short even without prior airway ultrasound experience.
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