SYSTEMATIC REVIEW article
Front. Surg.
Sec. Pediatric Surgery
This article is part of the Research TopicState of the Art in Acute Care Surgery: Application, Innovation, and Future PerspectivesView all 16 articles
Exploring the role of trained surgical care nurses in cricothyrotomy and other emergency procedures: A systematic review and meta-analysis
Provisionally accepted- The Second XiangYa Hospital of Central South University, Changsha, China
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Background: There is a severe shortage of healthcare professionals, emphasized in a stark manner by the recent COVID-19 pandemic, where the mortality rate was primarily a consequence of medical professionals lacking the technical know-how for conducting specialized procedures. Therefore, this systematic review and meta-analysis aimed to evaluate the success rates of nurse-performed emergency surgeries, focusing on trauma care (e.g., cricothyrotomy), rural obstetric emergencies (e.g., caesarean section, hysterectomy), and general procedures (e.g., laparotomy, appendectomy). Methods: A systematic search was conducted across eight major databases (PubMed, Embase, CINAHL, Scopus, Web of Science, PsycINFO, Cochrane Library, ProQuest) following PRISMA guidelines. Four eligible studies were identified, and data were pooled using a fixed-effects model. Results: The synthesis of data across the four selected studies revealed a pooled relative risk (RR) of 0.88 (95% CI: 0.78, 1.00) and odds ratio (OR) of 0.80 (95% CI: 0.65, 0.99) about the efficacy in emergency surgeries conducted by nurses. These four studies were the only ones meeting our strict inclusion criteria of reporting outcome data on nurse-performed emergency procedures. An analysis of heterogeneity demonstrated minimal variability among the studies, with a Chi² value of 1.54, df = 3, P = 0.67, and I² = 0%. The test for overall effect yielded a statistically significant Z statistic of 2.03 (P = 0.04), indicating a meaningful finding. The observed inferences also showed that the surgical procedures exhibited minimal complications. Conclusion: This study suggests that trained nurses can safely and effectively perform selected emergency surgical procedures. While encouraging, the limited number of studies highlights the need for further research to confirm these findings and guide clinical practice.
Keywords: Emergency surgery, Nurses, success rates, Systematic review, Meta-analysis
Received: 16 Jan 2025; Accepted: 24 Nov 2025.
Copyright: © 2025 Wang, Li, Shen, Yang, Zhang and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Huiping Wang
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
