Placement of a Word catheter: a resident training model.

OBJECTIVE: The present study developed and evaluated a practical teaching model and training protocol for Word catheter placement in the treatment of a Bartholin gland cyst. STUDY DESIGN: Residents were asked to treat a model of the female perineum, fashioned from harvested porcine tissue, with a simulated Bartholin cyst via Word catheter placement and drainage. Each resident was evaluated for procedural competence. They were retested after the viewing of a continuous 59-second video demonstrating catheter placement. RESULTS: The model's resemblance to female genitalia was confirmed by 68% of residents. Correct diagnosis and treatment of a Bartholin gland cyst was made by 61%. The mean pretraining score was 5.5 +/- 1.46, while the post-training average was 8.2 +/- 1.20, indicating an approximate 58% increase in resident proficiency (P < .05). CONCLUSION: A model of the female perineum fashioned from harvested porcine tissue is a suitable instructional aid in the recognition and treatment of a Bartholin cyst. Proficiency in Word catheter placement is improved through the use of the model and instructional video.

The effect of vinegar on colorimetric end-tidal carbon dioxide determination after esophageal intubation.

This study examines the effect of vinegar placement in the stomach on colorimetric end-tidal carbon dioxide (ETCO(2)) determinations after esophageal intubation. Using a blinded, prospective, before and after post-mortem swine model, colorimetric ETCO(2) was determined after aspiration of the stomach contents and after placement of aliquots of saline and vinegar. Data were compiled from 12 swine within 120 min post-mortem. In 12 of 12 trials, the ETCO(2) detector turned yellow, indicating "positive" determination of CO(2), but did not return to "purple" with multiple insufflations with 100% O(2). We conclude that esophageal intubation with a small amount of vinegar in the stomach can cause an irreversible color change of the detector to yellow. Color change indicating the presence of carbon dioxide without subsequent color change back to purple with insufflation with 100% oxygen should arouse suspicion of improper placement of the endotracheal tube.