A thoracoscopic cadaveric teaching model for needle decompression of a tension pneumothorax

Abstract

IntroductionThe purpose of this study was to evaluate the use of a cadaveric teaching model for needle compression of pneumothorax simulated by thoracoscopy.Materials and methodsA standardized didactic instruction was provided to medical personnel participants at a single institution tertiary medical center. A thoracoscope was inserted into cadavers and insufflated to 20 mm Hg for simulation of a tension pneumothorax. The study participants performed six needle decompressions (3 anterior, 3 lateral), which were all directly observed thoracoscopically. Demographic data and post-surveys were obtained. The primary endpoint was participant assessment of this teaching model for a simulated pneumothorax. Secondary endpoints were successful decompression of the pneumothorax, perceived success of each attempt, and injury to intrathoracic structures.ResultsForty participants completed 240 attempted decompressions. Participants reported that 43% had taken ATLS, and 63% had performed a needle decompression on a simulated patient prior to this study. The rate of successful decompressions was 85.86%. Participants reported a perceived successful completion rate of 82%. 73.7% performed this safely, while 88.5% perceived that they performed it safely. 85.7% stated that they felt more confident and capable after the study.ConclusionA simulated model is essential for adequate teaching. Our use of a thoracoscopic cadaveric model provides a realistic simulation of the pneumothorax used for training. Participants had similar rates of actual completion and perceived completion including higher rates of perceived safety. Further use of this model as a teaching tool will potentially improve the success of this life-saving procedure.