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Fig 1.

Overview of laryngeal and upper tracheal anatomy.

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Fig 2.

A. Representative bronchoscopic images of scalpel technique. (A) Scalpel insertion into tracheal lumen; (B) Blunt plastic end of scalpel seen in tracheal lumen, enlarging scalpel incision before insertion of bougie; (C) Bougie insertion; (D) Insertion of 6.0 endotracheal tube over bougie. B. Representative bronchoscopic images of Seldinger technique. (A) Needle insertion; (B) Needle appropriately directed inferiorly before wire insertion; (C) Wire advancing through trocar needle; (D) Scalpel enlarging trocar needle incision before dilator insertion; (E) Introducer tip placed over wire; (F) Tracheostomy tube and balloon entering tracheal lumen.

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Fig 3.

Bronchoscopic capture of complications with depiction of the midpoint of the anterior-posterior depth of the trachea.

(A) Scalpel puncture of posterior tracheal wall at 4 o’clock position; (B) Scalpel puncture of posterior tracheal wall at 7 o’clock position; (C) Needle puncture of posterior tracheal wall at 6 o’clock position; (D) Needle puncture of posterior tracheal wall at 7 o’clock position; (E) Absence of bougie catheter in trachea after being placed lateral to trachea.

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Table 1.

Puncture-to-Tube time stratified by cricothyrotomy technique.

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Table 2.

Published cricothyrotomy training programs using human cadavers: Characteristics and data.

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Table 3.

Evidence for a bronchoscopic training effect from live viewing of colleagues’ sharp instrument errors.

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Table 4.

Quantitative pre- and post-session survey results.

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