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INTRODUCTION

It is difficult to teach airway management well. Even with a comprehensive immersion experience in airway management, it is a challenge to have the student learn and retain the skills necessary to provide safe and competent airway management. This chapter serves as the syllabus for the development of an airway management education program that places particular emphasis on the identification and management of the difficult and failed airway through the application of simple, easily applied, hands-on experiences. Our goal is that it should be applicable to both academic providers as well as private practice practitioners to improve both their airway management skills as well as the skills and performance of their health care team.

Gas exchange and oxygenation are fundamental for successful airway management. When airway providers are focused on performing laryngoscopy and intubation, critical hypoxemia can occur in the absence of sufficient oxygenation resulting in catastrophic complications including hypoxic brain injury, cardiac dysrhythmias, and possibly cardiac arrest. Thus, an educational program intended to teach airway management must craft educational objectives that support this essential goal. The program of instruction must embrace the knowledge and skills that constitute the current standard of care, and, in addition, teach best practices related to the provision of gas exchange and oxygenation for those patients that require airway management.

The objectives of a comprehensive airway program should contain five components:

  1. Needs assessment: specific to the needs of the local institution place or practice identifying current training and practice issues.

  2. Cognitive or didactic component: may be accomplished with either a self-guided reading program or a series of focused lectures delivered in person or online; virtually or as a prerecorded webinar.

  3. Skills development component: a “hands-on” laboratory that teaches the nuances of the devices identified as “the standard of care,” and other relevant devices as supported by the local needs assessment, as well as best practice-based evidence and expert consensus.

  4. Practical real-time experience: an opportunity to “put it all together” with hands-on cases that simulate a real-life situation.

  5. Evaluation: this should be directed at both the evaluation of the program and self-evaluation and reflection for the participant.

This chapter will focus on providing guidance for the development and execution of an airway management and difficult airway educational program in one’s own institution or place of practice. The following areas will be discussed:

  • The problem.

  • The evidence that simulation works, improving patient safety through education, training, and research.

  • A detailed review of the devices a practitioner might easily use to start a local simulation program.

  • A curriculum focused on a needs assessment for your institution and the acquisition of requisite knowledge, skills, and behavior necessary to safely and competently perform airway management.

  • A skeleton for a context-sensitive training program—i.e., point-of-care or in-situ simulation.

What Problems Are We Facing in Airway Management?

Airway management is the ...

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