If you don’t get a chance to go see it in the hall here it is. It’s a pretty big file so you might have to click on it and scroll around a bit.
Of note I’ve removed a few of the dissection images as we don’t like to publish them freely online.
The paper that accomplishes this can be found here.
Hi Andy..nice work mate.
P.S. Did you calculate p values?
ah p-values… the most useless of all the values…
technically the med students did better than the junior doctors (3 out of 4 vs 5 out of 10) but i thought it best not to mention that.
The poster was fun to do, i’d never done one before now. It got people’s attention a bit at least.
You missed a good conference too mate. Hope all’s well in the other down under!If you’re ever in Dublin or up north, let me know!
Andy
Hi Andy… without p values, how can you make a recommendation when there is no way you can be sure that your results are not (and considering how small your series is) due purely to chance? Personally, having analysed the maths behind p values I find them very useful….or am I missing something here?
Ah… I get you now – I wasn’t dissing the whole idea of p-values, just that when the numbers are so small in a study like this i thought confidence intervals would be so wide that it would make a farce of calculating p-values. With only 14 procedures I figures that I didn’t need a p-value to tell me whether or not any comparisons were due to chance or not – I’m pretty sure if we re-did the study with the exact same people we’d find quite different results.
The other thing is this is a purely observational study, I wasn’t trying to compare any techniques – I just wanted to show it was feasible
What do you think – would p-values be useful in a study this small? Surely they’d be a tad redundant?
I’m a little suspicious of medical statistics as I think we give p- values more credence than study design. If the study design is faulty then no matter what the p values say they might be incorrect in their conclusions.
I think Andy is right here. Statistical analysis on data that is so small is almost certainly useless.
In this study you are really just looking at whether it is feasible or not. I think Andy has answered that question. As for p-values…well what are we comparing? Grade and experience? Not that helpful really as numbers are tiny.
Could you calculate a confidence interval for the overall proportion? Yes you could and that would be something like…
Overall success = 57% (95% CI 31.07-82.93)
So, you could do it, but why would you? Oh, I just did! Does it help us?
Not really.
S
http://www.stemlynsblog.org
This is what I have to say about surgical airway utilization in general:
Everyone always waits until the patient is already dead before they implement the surgical airway. Improved training will facilitate recognition in the caregivers that the primary, secondary, tertiary and quartenary plans have failed, and the surgical airway plan must be implemented straight away to avoid permanent neurologic disability or death of the patient.
I have two surgical airway experiences–one in training, one in practice. The experience I had in practice involved an 18 gauge IV through the cricothyroid membrane with jet ventilation to stabilize the patient while my senior partner was able to complete the intubation via DL. The jet ventilation stabilized the low SpO2 from the 40’s up to the 80’s and low 90’s while my colleague worked from above. Jet ventilation will give you TIME that you normally don’t have. If you decide to learn it, buy a jet ventilator, don’t try to make your own, that’s baloney. These things are cheap, and allow you to limit your insufflation pressure to a preset setting. Without the gauges of a formal jet vent, you have no idea how much pressure you are delivering. That baloney. Limit pressure between 22 – 26 psi, and use an 18-14 gauge IV catheter. The 18 gauge catheter worked in my case (bigger is not necessarily better—it’s jet ventilation).
great points Jim
I think the big thing I’ve learned recently is to act before the pt is actually dead!