Airway Management

The Anesthesiology Department has adopted a difficult airway management protocol based on both the  American Society of Anesthesiologists guidelines1, as well as the  European Difficult Airway Society protocol2.  Using these guidelines we have identified three airway management skills which we believe must be mastered by all residents.  These skills are:

  • Fiber optic intubation
  • Intubation using an Intubating Laryngeal Mask
  • Cricothryoidotomy

Assessment is an important part of effective education.  It is our Department’s policy that residents demonstrate a level of competency in the Simulation Laboratory before attempting these skilled procedures on patients.

  • The logistic problem we were faced with was how do we assess:
  • A large number of residents (approximately 24)
  • Performing 3 different procedures (listed above)
  • Within 2 hours (the out of OR lecture time available)
  • Using only one faculty member (all that could be spared due to clinical production demands)
  • Using an objective standardized test?

Please visit our Airway Assessment Management site describing our solution

We believe that the proposed solution can be adapted to many other training programs facing the same logistic problems.

References

  1. American Society of Anesthesiologists Task Force. Practice Guidelines for Management of the Difficult Airway: An updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology 2003;98:1269-77.
  2. Henderson JJ, Popat MT, Latto IP, Pearce AC. Difficult Airway Society guidelines for management of the unanticipated difficult intubation. Anaesthesia 2004; 59: 675-694.