Improving Competency in Emergency Airway Management through Multimodal
Simulation-Based Training
Abstract
Introduction: Emergency airway management necessitates decisive action
by all involved in the care of the patient, yet there is no standardized
method for teaching these skills. The goal of this quality improvement
project was to design and implement a simulation-based departmental
training course aimed at otolaryngology-head and neck surgery residents
and surgical technologists focusing on airway management. Methods: This
was a single-center departmental quality improvement project. A one-day
course in July 2019 consisted of five instructional stations including
an adult airway management and fiberoptic intubation, endotracheal
intubation and surgical airway management, pediatric airway management,
rigid bronchoscopy, and emergency airway supplies. Participants
completed a pre-test knowledge assessment and a survey of their comfort
level as well as various timed procedures. After the course,
participants completed another knowledge assessment and survey of
comfort level. Results: A total of 18 participants completed the course.
The average knowledge test scores improved significantly from 59.1% to
75.8% following training (p=0.02). The average levels for comfort with
all aspects of airway management significantly increased after
completing the course. The time to successful endotracheal intubation
with video-assisted laryngoscopy improved from 88.3 seconds before the
course to 29.7 seconds after instruction (p=0.001). Conclusion:
Implementation of a departmental emergency airway management course is
feasible and useful for both residents and novices, including surgical
technologists, to be able to assist in these high-stakes situations.