Efficacy of a theoretical and practical course in learning difficult airway predictors
##plugins.themes.bootstrap3.article.main##
Introduction: The management of a difficult airway is a high impact issue in the survival of critical patients admitted to emergency services. The starting point in this management is the correct identification of difficult airway predictors. This study evaluates the effectiveness of a course (that combines theory and practice) in the learning of 15 features that predict a difficult airway. Methodology: it was done a review of scores of tests conducted before
and after the completion of a course on difficult airway in the emergency department, making emphasis on meaning questions of three acronyms that summarize 15 characteristics to be evaluated to identify difficult airway predictors. The participants of this course were medical doctors who received a textbook, a month before starting the course. This textbook included the theoretical concepts to be evaluated. During the course, doctors received theoretical lessons and participated actively in workshops with high accurateness mannequins to practice airway management techniques. For statistical analysis it was used the Shapiro Wilk T Student and Wilcoxon tests. Results: After analyzing the results obtained before and after the course, it was found a statistically significant difference for the global assessment of knowledge about the management of a difficult airway p<0.001. Likewise, a significant improvement was found when assessing the specific questions about difficult airway predictors using 3 acronyms that group 15 features: MOANS p<0.001, LEMON p<0.001, SHORT p<0.001. Conclusión: The use of a difficult airway management course in the emergency setting that combines lectures and workshops using high accuracy mannequins is an efficient tool in the teaching of difficult airway predictors.
Downloads
##plugins.themes.bootstrap3.article.details##
American Society of Anesthesiologists Task Force on Guidelines for Management of de Difficult Airway. Anesthesiology 1993; 78:597.
Caplan RA, Posner K, Ward RJ, et al: Adverse respiratory events in anesthesia: A close claims analysis. Anesthesiology 1990;2:828.
Reed Allan. Evaluation and recognition of the difficult airway. In Benumof´s Airway Management, 2nd Ed. Mosby 2007;221-235.
Bustos Y, Castro J, editores. AIRE: Apoyo Integral Respiratorio en Emergencias. 1 ed. Colombia: Editorial Rosarista; 2011.
Walls RM. Rapid-sequence intubation comes of age. Ann Emerg Med 1996;28:79-81.
Samsoon GLT, Young JRB: Difficult traqueal intubation: A retrospective study. Anesthesia 1987;42:487.
Langeron O, Masso E, Huraux C, et al. Prediction of difficult mask ventilation. Anestesiology 2000;92:1229.
Miller CG. Management of the difficult intubation in closed malpractice claims. ASA Newsletter 2000; 64:13-16.
Cheney FW. Changing trends in anesthesiarelated death and permanent brain damage. ASA Newsletter 2002; 66: 6-8.
MJ Reed, M J G Dunn, DW McKeown. Can an airway assessment score predict difficulty at intubation in the emergency department?. Emerg Med J 2005;22:99-102.
Baker PA, Weller JM, Greenland KB, Riley RH, Merry AF. Education in airway management. Anaesthesia 2011;66 Suppl 2:101-111.
Gwinnutt CL. The interface between anaesthesia and emergency medicine. Emerg Med J 2001;18:325-326.
Levitan RM. A new tool for teaching and supervising direct laryngoscopy. Acad Emerg Med 1996;3:79-81.
Levitan RM. A new view on intubation training. Journal of Emergency Medical Services 1998;23:54-58.
Levitan RM, Goldman TS, Bryan DA, et al. Training with video imaging improves the initial intubation success rates of paramedic trainees in an operating room setting. Ann Emerg Med 2001;37:46-50.
Forrest FC, Taylor MA, Postlethwaite K, et al. Use of a high-fidelity simulator to develop testing of the technical performance of novice anaesthetists. Br J Anaesth 2002;88:338-344.
Glavin RJ, Maran NJ. Development and use of scoring systems for assessment of clinical competence. Br J Anaesth 2002;88:329-330.
Walls RM, Murphy MF, et al. Manual of emergency airway management. Philadelphia, PA: Lippincott, Williams and Wilkins, 3rd edition. 2008.
Kai Goldmann Education and training in airway management. Best Practice & Research Clinical Anaesthesiology 2005;19(4):717-732.
Hagberg CA, Greger J, Chelly JE, Saad-Eddin HE: Instruction of airway management skills during anesthesiology residency training. J Clin Anesth 2003;15:149-153.
Gaba DM. Structural and organizational issues in patient safety. Calif Manage Rev 2000;43:83-102. 22. Maran NJ, Glavin RJ. Low- to high-fidelity simulation da continuum of medical education? Med Educ 2003;37(Suppl 1):22-28.
Rosenthal ME, Adachi M, Ribaudo V, et al. Achieving housestaff competence in emergency airway management using scenario based simulation training. Chest 2006;129:1453-1458.
Mayo PH, Hackney JE, Mueck T, et al. Achieving house staff competence in emergencyairway management: results of a teaching program using a computerized patient simulator. Crit Care Med 2004;32:2422-2427.
Goldmann K, Ferson D. Education and training in airway management. Best Pract Res Clin Anaesthesiol. 2005 Dec;19(4):717-732.
Koppel JN, Reed AP. Formal instruction in difficult airway management: a survey of anesthesiology residency programs. Anesthesiology 1995;83:1343-1346.
Russo S, Eich C, Barwing J, et al. Self-reported changes in attitude and behavior after attending a simulation-aided airway management course. J Clin Anesth 2007;19:517-522.
Chen P, Cheng H, Chia R, et al. Instructor-based real-time multimedia medical simulation to update concepts of difficult airway management for experienced airway practitioners. J Chin Med Assoc 2008;71(4):174-179.