Learning fibreoptic intubation: fundamental problems

Training in airway management

“…However, an alternative source of awake patients on which to learn fibreoptic skills is the bronchoscopy clinic. It has been suggested that joint involvement of anaesthetists and physicians in these clinics can be beneficial to both parties [64]. As the procedure is usually performed under local anaesthesia, it provides similar conditions to those encountered during awake fibreoptic intubation.…”

“…Another modification allows nasotracheal fibreoptic intubation via an aperture cut in the posterior aspect of the distal tube of the laryngeal mask airway [87]. However, it should be pointed out that any .............................................................................................................................................................................................................. Fibreoptic intubation via the nasal route has traditionally been thought of as the easier technique to master [64,91], but a recent study showed no advantage or disadvantage in learning first via the oral or the nasal route [92]. Therefore, training can be planned according to the availability of patients rather than targeting only those requiring nasal intubation.…”

Acquisition and maintenance of endoscopic skills: developing an endoscopic dexterity training system for anesthesiologists

“…14 ,19 The psychomotor component of endoscopic airway management is recognized as the hardest to learn and the easiest to lose. 9,10 The related concepts can be thought of as dexterity deficit and dexterity decay.…”

“…9,10,16 The determinants of practice also need consideration. These include incentive, opportunity and reward.…”

“…[1][2][3][4] The role of fibreoptic intubation in situations of both recognized and unrecognized difficult intubation is well established. [5][6][7][8] The requirement for fibreoptic equipment, trained personnel and for the teaching of trainees and staff is internationally acknowledged 9,10 and highlighted by accreditation, 11 audit 3 and professional bodies. 5 Fibreoptic intubation has become a standard of practice and numerous educational resources are available, detailing relevant patient management, anatomy, endoscopic techniques and equipment.…”