Department of Anesthesiology and Pain Medicine, Harborview Medical Center, Seattle WA 98195-9724, USA.
Respir Care. 2012 Jul;57(7):1084-8. doi: 10.4187/respcare.01540.
Intensivists may be primarily responsible for airway management in non-operating room locations. Little is known of airway management training provided during fellowship.Our primary aim was to describe the current state of airway education in internal medicine-based critical care fellowship programs.
Between February 1 and April 30, 2011, program directors of all 3-year combined pulmonary/critical care and 2-year multidisciplinary critical care medicine programs in the United States were invited to complete an online survey. Contact information was obtained via FRIEDA Online (https://freida.ama-assn.org). Non-responders were sent automated reminders, were contacted by e-mail, or by telephone.
The overall response proportion was 66% (111/168 programs). Sixty-four (58%) programs reported a designated airway rotation, chiefly occurring for 1 month during the first year of training. Thirty-five programs (32%)reported having a director of airway education and 78 (70%) reported incorporating simulation based airway education. Nearly all programs (95%) reported provision of supervised airway experience during fellowship. Commonly used airway management devices, including video laryngoscopes,intubating stylets, supraglottic airway devices, and fiberoptic bronchoscopes, were reportedly available to trainees. However, 73% reported < 10 uses of a supraglottic airway device, 60% < 25 uses of intubating stylets, 73% < 30 uses of a video laryngoscope, and 65% reported < 10 flexible fiberoptic intubations. Estimates of the required number of procedures to ensure competence varied widely.
The majority of programs have a formal airway management program incorporating a variety of intubation techniques. Overall experience varies widely, however.
在非手术室环境中，重症医师可能主要负责气道管理。关于 fellowship 期间提供的气道管理培训，我们知之甚少。我们的主要目的是描述内科重症监护 fellowship项目中气道教育的现状。
2011 年 2 月 1 日至 4 月 30 日，邀请美国所有 3 年联合肺/重症监护和 2 年多学科重症监护医学项目的项目主任完成在线调查。通过 FRIEDA Online（https://freida.ama-assn.org）获得联系信息。对未回复者发送自动提醒，通过电子邮件或电话联系。
总体回复率为 66%（111/168 个项目）。64 个（58%）项目报告了指定的气道轮转，主要在培训的第一年进行 1 个月。35 个项目（32%）报告有气道教育主任，78 个（70%）报告采用模拟气道教育。几乎所有项目（95%）报告在 fellowship期间提供有监督的气道经验。受训者可获得常用的气道管理设备，包括视频喉镜、插管导丝、声门上气道装置和纤维支气管镜。然而，73%的项目报告使用声门上气道装置的次数<10 次，60%的项目报告使用插管导丝的次数<25 次，73%的项目报告使用视频喉镜的次数<30 次，65%的项目报告使用纤维支气管镜的次数<10 次。估计确保熟练掌握所需的程序数量差异很大。
大多数项目都有一个正式的气道管理计划，其中包括各种插管技术。然而，总体经验差异很大。
