Design and Implementation of an Educational Program in Advanced Airway Management for Anesthesiology Residents

Abstract

Education and training in advanced airway management as part of an anesthesiology residency program is necessary to help residents attain the status of expert in difficult airway management. The Accreditation Council for Graduate Medical Education (ACGME) emphasizes that residents in anesthesiology must obtain significant experience with a broad spectrum of airway management techniques. However, there is no specific number required as a minimum clinical experience that should be obtained in order to ensure competency. We have developed a curriculum for a new Advanced Airway Techniques rotation. This rotation is supplemented with a hands-on Difficult Airway Workshop. We describe here this comprehensive advanced airway management educational program at our institution. Future studies will focus on determining if education in advanced airway management results in a decrease in airway related morbidity and mortality and overall better patients' outcome during difficult airway management.

A prospective, randomised, clinical study to compare the use of McGrath ® , Truview ® and Macintosh laryngoscopes for endotracheal intubation by novice and experienced Anaesthesiologists

“…[ 4 ] Airway learning for the novice anaesthesiologist, usually, starts with direct laryngoscopy and novel airway devices are dealt with in the advanced course. [ 5 ] With the current difficult airway algorithm supporting the use of VL, a few important questions that need to be answered are: (1) Does experience with MAC blade translate to better results at tracheal intubation with a VL? (2) What is the best time to introduce the technique of tracheal intubation using VLs to trainee anaesthesiologists?…”

Evidence base in airway management training

“…Borovcanin et al have recently applied many of the principles discussed in this review in order to establish the concepts of AWM rotations. 68 Such initiatives should be encouraged and promoted at all levels of anaesthesia training.…”

Assessing anesthesiology residents’ out-of-the-operating-room (OOOR) emergent airway management

“…[ 17 , 29 ] With only approximately one-third of anesthesiology residency programs offering focused training in advanced airway management, anesthesiology residents may not have sufficient clinical exposure to be considered experts in difficult airway management. [ 30 ] Although there has been evidence that faculty presence at these events decreases the incidence of complications, this may not be feasible at all institutions due to lack of available resources. [ 3 ].…”

“…Programs that offer a curriculum in advanced airway management with defined objectives suggest that such training is crucial to increase airway management expertise. [ 30 , 35 ] Such a curriculum should also consider the addition of other available difficult airway algorithms that may be more appropriate during these events, such as the Difficult Airway Society algorithm. [ 36 ] A focused curriculum may also improve understanding of complications resulting in and from unplanned tracheal extubation as well as enhancing accuracy in identifying the cricothyroid membrane.…”