Training

Introduction

The airway is the most important priority in the management of acutely ill patients. Every resuscitation protocol like basic life support, advanced trauma life support states that the airway is the first priority for assessment and intervention. Failure of airway management remains a significant source of morbidity and mortality.

Training healthcare professionals in airway management is essential to patient safety and survival. Simulation training offers a controlled, safe, and reproducible environment in which healthcare workers can practice and gain mastery in emergency airway management skills. It has been shown to be effective in acquiring clinical skill proficiency and improving performance in actual clinical situations. It can effectively enhance and upgrade the knowledge and skills of the trainees and which subsequently decreases medical errors and improve patient outcomes and safety.

Objective

To enhance knowledge, skills, and confidence associated with emergency airway management among healthcare workers through a simulation exercise

Specific Objective

1. To assess the level of competency acquired by healthcare workers in basic airway management skills, intubation, Laryngeal Mask Airway insertion, and needle cricothyroidotomy via simulation-based exercise based on knowledge questionnaire and skill checklist (American heart Association-based)
2. To assess the level of confidence acquired by healthcare workers in emergency airway management maneuvers before and after simulation-based training

Duration: ½ day

Mode of Teaching: Case-based Simulation exercise (Trauma-based Case scenarios)

1st scenario: A Trauma patient who needs immediate airway assessment and intervention

2nd scenario: A conscious trauma patient, who needs rapid sequence intubation will be introduced to healthcare workers for emergency airway management in dummy patients.

Target group: Inter medical student, MDGP Resident, Anesthesia Resident, ENT resident, Medical officers, Emergency, ICU, Medicine, PICU, pediatric, SICU, MICU,- Nursing and paramedics staff, Newly appointed faculty of Emergency, Anesthesia, and ENT Department.

1. Significance: This training provides the required knowledge, skills, and attitudes for basic, advanced airway maneuvers, insertion of laryngeal mask airways, and needle cricothyroidotomy which in turn enables them to utilize the skills for diagnosing and managing airway compromises. This enhances the level of confidence and minimizes the error during the identification and management of a compromised airway. It can reinforce the resuscitating team and can save more lives.

Simulation-based Airway Management Workshop

Schedule

Content	Time	Responsible person			Remarks
Registration	5 mins
Welcome	5 mins
Expectation and Ground Rules	5 mins
Pre-test- Theory	10 mins
Pre-test – Practical with debriefing	20 mins
Airway overview	60 mins
Skill stations
Demonstration on Basic Airway maneuver and Practice (head tilt, chin lift, jaw thrust, oxygen administration, suction, Oro-pharyngeal Airway, Nasopharyngeal Airway, Bag and mask, C-spine protection)	30 mins				Skill station-1
Demonstration of LMA on a mannequin and practice	30 mins				Skill station-2
Advanced Airway ( Intubation, Crash Airway, and Rapid Sequence intubation) and Practice	30 mins				Skill station-3
Demonstration on Needle Cricothyroidotomy, Teamwork and practice	30 mins				Skill station-4
Team-Break                                                     10 mins
Practice session	15 mins
Post  practical test and debriefing	25  mins
Post theory test	10 mins
Feedback  from participants	5 mins
Feedback from faculties	5 mins
Closing	5 mins

 

There will be 4 skill stations. All participants will be divided into 4 groups and in  each group there will be 4-7 participants with one Trainer/ Facilitator. There will be one rotatory facilitator who rotates all the group members in each skill station and will make sure each member has received enough practice sessions.

1. Preparation phase and Basic Airway maneuver
2. Laryngeal mask airway insertion
3. Intubation: Rapid Sequence
4. Needle cricothyroidotomy

Debriefing

After completion of managing that trauma victim, then, 25-30 minutes debriefing session will be conducted based on Pendleton’s rule by the faculty being as a moderator.  What went well, what needs to be corrected, and what needs to be demonstrated will be discussed and demonstrated to the healthcare workers in the debriefing session (feedback session).

Skill checklist (American heart association- basic airway maneuver, intubation, Laryngeal mask insertion, directly observed procedural Skills) will be followed to assess the skill. Each element of the skill test will be categorized into 3 parts i.e satisfactorily performed, not satisfactorily performed, and not observed.

Contact Person: Dr. Samjhana Basnet

Department of General Practice and Emergency Medicine

drbasnets@gmail.com

9851205097