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英国的高级气道培训:一项针对高级麻醉住院医师的全国性调查。

Advanced airway training in the UK: A national survey of senior anesthetic trainees.

作者信息

Boulton Adam J, Balla Sunita R, Nowicka Aleksandra, Loka Thomas M, Mendonca Cyprian

机构信息

University of Warwick, Medical School Building, Coventry, CV4 7AJ, UK.

University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, UK.

出版信息

J Anaesthesiol Clin Pharmacol. 2019 Jul-Sep;35(3):326-334. doi: 10.4103/joacp.JOACP_325_18.

Abstract

BACKGROUND AND AIMS

High-quality training in advanced airway skills is imperative to ensure safe anesthetic care and develop future airway specialists. Modern airway management skills are continually evolving in response to advancing technology and developing research. Therefore, it is of concern that training provisions and trainee competencies remain current and effective.

MATERIAL AND METHODS

A survey questionnaire based on the airway competencies described in the Royal College of Anaesthetists' curriculum and Difficult Airway Society guidelines was posted to all United Kingdom (UK) National Health Service hospitals to be completed by the most senior anesthetic trainee (ST 5-7, resident).

RESULTS

A total of 149 responses were analyzed from 237 hospitals with eligible anesthetic trainees (response rate 63%), including 53 (36%) and 39 (26%) respondents who had completed higher and advanced level airway training respectively. Although clinical experience with videolaryngoscopy was satisfactory, poor confidence and familiarity was identified with awake fiberoptic intubation, high frequency jet ventilation, at risk extubation techniques, and airway ultrasound assessment. Only 26 (17%) respondents had access to an airway skills room or had regular airway emergency training with multidisciplinary theater team participation. Reported barriers to training included lack of training lists, dedicated teaching time, experienced trainers, and availability of equipment.

CONCLUSIONS

This national survey identified numerous deficiencies in airway competencies and training amongst senior anesthetic trainees (residents) in the UK. Restructuring of the airway training program and improvements in access to training facilities are essential to ensure effective airway training and the capability to produce future airway specialists.

摘要

背景与目的

高质量的高级气道技能培训对于确保安全的麻醉护理以及培养未来的气道专科医生至关重要。随着技术的进步和研究的发展,现代气道管理技能也在不断演变。因此,培训内容和学员能力能否与时俱进并保持有效性令人担忧。

材料与方法

一份基于皇家麻醉师学院课程和困难气道协会指南中描述的气道能力的调查问卷被发送至英国所有国民健康服务医院,由最资深的麻醉学员(ST 5 - 7,住院医生)填写。

结果

对来自237家拥有符合条件麻醉学员医院的149份回复进行了分析(回复率63%),其中分别有53名(36%)和39名(26%)受访者完成了高级和进阶气道培训。尽管视频喉镜的临床经验令人满意,但在清醒纤维支气管镜插管、高频喷射通气、高危拔管技术和气道超声评估方面,受访者的信心和熟悉程度较差。只有26名(17%)受访者能够使用气道技能室或参加多学科手术团队参与的常规气道应急培训。报告的培训障碍包括缺乏培训清单、专门的教学时间、经验丰富的培训师以及设备的可用性。

结论

这项全国性调查发现,英国高级麻醉学员(住院医生)在气道能力和培训方面存在诸多不足。重组气道培训计划并改善培训设施的可及性对于确保有效的气道培训以及培养未来气道专科医生的能力至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb42/6747995/26bfd7d47752/JOACP-35-326-g001.jpg

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