Airway Management is a unique rotation for medical providers to learn, practice, and demonstrate their ability in applying airway skills in a controlled environment.
Operating room assignments are deliberately made to enhance the opportunity of practicing airway techniques in the operating room.
Airway maneuvers in the operating room are always performed in a controlled manner, with faculty present, so the safety of the patient is ensured.
Goals & Objectives
- Identify risk factors for difficult mask ventilation
- Identify risk factors for difficult intubation
- Identify risk factors for difficult tracheostomy
- Know indications for a rapid sequence induction and intubation
- Know contraindications for a rapid sequence induction and intubation
- Know contraindications for succinylcholine
- Know differences between the pediatric airway and adult airway
Performance will be evaluated by a pre- and post-test. A passing score will be 70% on the post-test
- Demonstrate ability to properly position a patient
- Demonstrate ability to bag mask ventilate a patient (1 and 2 handed)
- Demonstrate ability to place an oral and nasal airway
- Demonstrate ability to place an LMA
- Demonstrate ability to perform direct laryngoscopy
- Demonstrate ability to use an airway bougie
- Demonstrate ability use a video laryngoscope
Performance will be evaluated by demonstration of good technique
- Meet with the anesthesia provider before the case starts to introduce yourself
- Introduce yourself to the patient and perform an airway exam
- Identify any airway concerns and discuss the management of the airway with the anesthesia provider
- Pre-oxygenate the patient and perform bag mask ventilation when appropriate
- Perform or assist with placement of LMA, direct laryngoscopy, or video laryngoscopy
- Assist or observe advanced instrumentation of the airway
- Be available for feedback on performance
- Rotators will keep track of the number of patients they take care of, the number of LMAs they attempt to place, the number of direct laryngoscopies they attempt, and the number of video laryngoscopies they attempt. Rotators should also keep track of how many pediatric airways they manage.
Performance will be by evaluations handed by the rotator to an anesthesiologist on a day they feel they performed well, once a week
Expectations For Me
- I, or someone from the department, will connect the night before with Dr. Giordano, Dr. Martin, Ms. Aminzadeh, Ms. Ford, and Ms. Massey to find out which rooms the AAs, SRNAs, medical students, and CA-1s in their first 6 months of training are placed in.
- During the first week, I, or Mr. Levites, will place the rotator in one room to participate in airway management and seek feedback during the course of the morning.
- For the last 3 weeks, I, or Mr. Levites, will connect with rotators with 4 – 5 rooms for them to potentially participate in patient care.
- If possible, I will try to place Emergency Medicine Residents in a pediatric room once a week.
- I, or another anesthesiologist, will be available or find a stand-in to teach in the simulator during the first week of each rotation.
- I will provide feedback to respective departments on rotators performance.
- Practice Guidelines for Management of the Difficult Airway 2013
- A Report by the American Society of Anesthesiologists
- Task Force on Management of the Difficult Airway. Feb 2013
- Core topics in airway management
- Basic discussion of core skills and knowledge required to manage airways in a wide variety of patients and clinical settings.
- The Difficult Airway
- An Atlas of Tools and Techniques for Clinical Management