Kei Jonathan, Jang Nathan, Silver Matthew
Department of Emergency Medicine, Kaiser Permanente San Diego Medical Center, San Diego, CA, USA.
Perm J. 2025 Mar 14;29(1):50-60. doi: 10.7812/TPP/24.118. Epub 2024 Dec 9.
As airway management becomes more complex with the adoption of new technologies and strategies, it is important to ensure that emergency medicine residents, the future of the specialty, receive extensive training. This study was designed to understand the prevailing airway management practices and training within emergency medicine residency programs.
A survey consisting of 19 multiple-choice questions was sent to program directors of 258 emergency medicine residency programs in the United States.
A total of 63 emergency medicine residency programs completed the airway survey, a response rate of 24%. Programs from all regions of the country are represented, most of them from university-based teaching hospitals (40%) and 3-year programs (78%). The majority of programs provide their residents with 50-100 intubations (50.8%) during their training. Pediatric intubations remain scarce with 54.1% of programs having only 5-10 pediatric intubations per resident. The emergency medicine team manages 93.6% of all trauma intubations, and residents complete 81% to 100% of all the department's intubations 88.9% of the time. Video laryngoscopy is on the rise, with GlideScope (93.7%) and C-Mac (55.6%) being the most common devices available. Overall, programs use both succinylcholine and rocuronium equally, but there is a trend toward using rocuronium more frequently than succinylcholine. By employing different teaching modalities, multiple times a year, residency programs expose residents to a variety of backup tools and surgical airway techniques.
Emergency medicine residents are exposed to multiple advanced airway adjuncts and comprehensive airway curriculums as emergency airway management practices evolve and become more complex.
随着新技术和策略的采用，气道管理变得愈发复杂，确保作为该专业未来主力军的急诊医学住院医师接受广泛培训至关重要。本研究旨在了解急诊医学住院医师培训项目中普遍存在的气道管理实践和培训情况。
向美国258个急诊医学住院医师培训项目的项目主任发送了一份包含19道选择题的调查问卷。
共有63个急诊医学住院医师培训项目完成了气道管理调查，回复率为24%。来自美国各个地区的项目均有代表，其中大多数来自大学附属医院（40%）以及为期3年的项目（78%）。大多数项目在培训期间为住院医师提供50 - 100次插管操作（50.8%）。儿科插管操作仍然较少，54.1%的项目每位住院医师仅有5 - 10次儿科插管经历。急诊医学团队负责管理所有创伤插管操作的93.6%，并且住院医师在88.9%的时间里完成了科室所有插管操作的81%至100%。视频喉镜的使用正在增加，GlideScope（93.7%）和C - Mac（55.6%）是最常用的设备。总体而言，项目对琥珀酰胆碱和罗库溴铵的使用频率相同，但存在罗库溴铵使用频率高于琥珀酰胆碱的趋势。通过每年多次采用不同的教学方式，住院医师培训项目让住院医师接触到各种备用工具和手术气道技术。
随着急诊气道管理实践不断发展并变得更加复杂，急诊医学住院医师接触到多种先进的气道辅助设备和全面的气道课程。
