Low-Fidelity Simulation of Airway Emergencies

Abstract

Objective: Junior trainees are commonly expected to manage airway emergencies with very little prior experience. The aim of this simulation training is to: 1) Be able to increase the confidence of participants in managing airway emergencies with respect to tracheostomies. 2) Learn the principles of performing a surgical cricothyroidomy.

Method: Design: Survey. Tertiary otolaryngology center. Junior doctors otolaryngology and anaesthesia. A half-day program in managing airway emergencies. Surgical cricothyroidotomy was taught (Killick artificial larynx). Algorithms on 2 complete airway scenarios (blocked/displaced tracheostomy and “can’t intubate, can’t ventilate”) were completed. Confidence in managing airway emergencies was evaluated (Likert scale).

Results: Previous exposure to airway emergencies was variable between the trainees. Universally, the trainees described a marked improvement in confidence following the practical and moulage sessions. Videos from these sessions will be available online to serve as a future teaching resource. The low-fidelity airway simulation has since been rolled out through regional hospitals led by senior residents, highlighting the utility of delivering basic airway training in a cost-effective manner.

Conclusion: A low-fidelity simulation-based training of airway emergencies can be effective in improving junior otolaryngology residents’ confidence, knowledge and technical skills. Further reinforcement of clinical and decision-making skills in realistic training scenarios may be achieved through high-fidelity simulation training.