Critical Airways: an educational initiative for professionals managing critically ill patients ́ airways

Background and Goal of Study:
Airway interventions in Critically ill patients are high risk procedures with the potential to cause permanent harm or death, as evidenced by the national audit undertaken by the Royal College of Anaesthetists and Difficult Airway Society1. The main objective of the “Critical Airways” programme is to improve the practical airway skills of students, with an emphasis on improving safety in the event of airway emergencies.

Materials and methods:
The one day course was divided into morning and afternoon sessions. The morning session consisted of a number of tutorials on the following key topics:

Complications of Airway Management
Non Technical Skills
Risk Management
Effects of Anaesthesia
Difficult Airways

The afternoon session consisted of five practical stations arranged in a circuit. The stations were designed to address five main airway skill sets in Critical Care:

Basic Airway Management 
Intubation
Difficult Airways 
Extubation
Tracheostomy Management 

Results and discussion:
The course was run twice in May and September 2015. In total 26 Candidates completed the course of whom 10 were doctors and 16 were nurses. A summary of the candidates' feedback is given in figure 1 below:

[Figure 1. Candidate Feedback]

Conclusion(s):

Within our institution the training needs of non-anaesthetists had not previously been addressed prior to the development of the “Critical Airways” course. The course may be of value to practitioners in other institutions, and we have already attracted interest from external candidates. Although there may be shifts in attitude for individual participants after undergoing training, it should be recognised that patient safety is dependent on a range of broader institutional factors2.

References:
1. Cook, T.M. Woodall N. et al (2011) Major complications of airway management in the UK: results of the 4th National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. British Journal of Anaesthesia 106 (5) 632-642
2. Vincent C (2003) Understanding and responding to adverse events. New England Journal of Medicine 348 (11) 1051-6

Critical Airways: an educational initiative for professionals managing critically ill patients´ airways