Department of Otolaryngology-Head and Neck Surgery, Naval Medical Center San Diego, San Diego, California, USA.
Department of Family Medicine, Naval Hospital Camp Pendleton, Oceanside, California, USA.
Otolaryngol Head Neck Surg. 2020 Aug;163(2):204-208. doi: 10.1177/0194599820902065. Epub 2020 Jan 28.
This course was designed to characterize the impact of a curriculum for training family medicine physicians in advanced airway techniques with respect to intubation performance and learner confidence.
A training course was introduced into the curriculum in a single-group pretest-posttest model at a community family medicine residency program. Training consisted of a didactic teaching session on airway management and hands-on skill session with direct laryngoscopy (DL) and video-assisted laryngoscopy (VAL) on normal and difficult airway simulators. Participants were scored with the Intubation Difficulty Scale and completed surveys before and after the training.
Twenty-eight residents of all levels participated. The mean time to successful intubation was significantly decreased after training from 51.96 to 23.71 seconds for DL and from 27.89 to 17.07 seconds for VAL. Participant scores with the Intubation Difficulty Scale were also significantly improved for DL and VAL. All participants rated their comfort levels with both techniques as high following training.
Advanced airway management is a critical skill for any physician involved in caring for critically ill patients, though few trainees receive formal training. Addition of an airway training course with simulation and hands-on experience can improve trainee proficiency and comfort with advanced airway techniques.
Training on airway management should be included in the curriculum for trainees who require the requisite skills and knowledge necessary for advanced airway interventions. This introductory project demonstrates the efficacy and feasibility of a relatively brief training as part of a family medicine residency curriculum.
本课程旨在描述针对家庭医学住院医师进行高级气道技术培训的课程对插管性能和学习者信心的影响。
在一个社区家庭医学住院医师培训计划中,采用单组预测试-后测试模型将培训课程引入课程。培训包括气道管理的理论教学和直接喉镜(DL)和视频辅助喉镜(VAL)在正常和困难气道模拟器上的实际操作技能课程。参与者使用插管难度量表进行评分,并在培训前后完成调查。
共有 28 名各级住院医师参加。培训后,DL 的成功插管时间从 51.96 秒显著缩短至 23.71 秒,VAL 从 27.89 秒显著缩短至 17.07 秒。DL 和 VAL 的参与者的插管难度量表评分也显著提高。所有参与者在培训后都表示对两种技术的舒适度均较高。
高级气道管理是任何参与危重病患者护理的医生的关键技能,尽管很少有受训者接受正规培训。添加带有模拟和实践经验的气道培训课程可以提高学员在高级气道技术方面的熟练程度和舒适度。
需要高级气道干预所需技能和知识的学员应将气道管理培训纳入课程中。这个入门项目展示了作为家庭医学住院医师课程一部分的相对简短培训的有效性和可行性。