Abstract
Tracheal suctioning is an important procedure to maintain airway patency by removing secretions. Today, suctioning operators include not only medical staff, but also family caregivers. The use of a simulation system has been noted to be the most effective way to learn the tracheal suctioning technique for operators. While the size of the trachea varies across different age groups, the artificial trachea model in the simulation system has only one fixed model. Thus, this study aimed to construct multiple removable trachea models according to different age groups. We enrolled 20 patients who had previously received proton beam therapy in our institution and acquired the treatment planning computed tomography (CT) image data. To construct the artificial trachea model for three age groups (children, adolescents and young adults, and adults), we analyzed the three-dimensional coordinates of the entire trachea, tracheal carina, and the end of the main bronchus. We also analyzed the diameter of the trachea and main bronchus. Finally, we evaluated the accuracy of the model by analyzing the difference between the constructed model and actual measurements. The trachea model was 8 cm long for children and 12 cm for adolescents and young adults, and for adults. The angle between the trachea and bed was about 20 degrees, regardless of age. The mean model accuracy was less than 0.4 cm. We constructed detachable artificial trachea models for three age groups for implementation in the endotracheal suctioning training environment simulator (ESTE-SIM) based on the treatment planning CT image. Our constructed artificial trachea models will be able to provide a simulation environment for various age groups in the ESTE-SIM.
Highlights
For patients on ventilators, tracheal suctioning to maintain airway patency by removing secretions could be a life-threatening procedure if performed incorrectly
We developed and operated the endotracheal suctioning training environment simulator (ESTE-SIM) which uses interactive vital reactions to change the patient’s condition according to the operator’s procedure (Fig 1) [10]
We generalized the artificial trachea model for three different age groups by using the treatment planning computed tomography (CT) images taken for proton therapy
Summary
Tracheal suctioning to maintain airway patency by removing secretions could be a life-threatening procedure if performed incorrectly. Due to the spread of home healthcare services, the operators of the tracheal suctioning include medical staff and family caregivers [1, 2]. Tracheal suctioning is a highly invasive procedure which involves risk factors such as damage of airway membrane and hemorrhage of tracheoinnominate artery [3,4,5]. There is the risk of respiratory obstruction, atelectasis, or aspiration, which increases if the operator hesitates [6, 7]. Simulation education has been attracting attention as an effective way to teach appropriate tracheal suctioning techniques that involve validated principles and rationale [8, 9]. A simulator has been developed which can quantitatively detect catheter operation in the respiratory tract model [10, 11]
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