Instruction of airway management skills during anesthesiology residency training

Difficult airway management is a critical aspect of anesthesiology training and practice. A survey was conducted of American anesthesia residency programs to determine the prevalence of a specific airway rotation and its curriculum.

A questionnaire was sent by both e-mail and fax to all 132 directors of American anesthesiology residency programs.

Of the 132 programs surveyed, 79 (60%) responded. Of the responders, 26 programs (33%) have a difficult airway rotation. The rotation was offered throughout the years of clinical training in 13 (49%) of the programs and was of 1-week duration in 16 (61%) of these programs who had a rotation. Formal instruction was administered before the rotation in 18 (69%) of the programs. Instruction was usually performed on surgical patients in 22 (85%) of the program, ASA status I and II patients in 20 (77%) of the programs, and taught by selected faculty in 20 (78%) of the programs. There was a 2- to 5-minute time limitation or a number of maximum attempts when using any of these devices in 16 (62%) programs. There was a case number requirement regarding the use of the devices in 5 (19%) of the programs. Residents were evaluated by both skills testing and written evaluation in 63% of these programs.

Of the programs with an airway rotation, the flexible fiberoptic bronchoscope and the laryngeal mask airway represent the most frequently used devices, excluding the standard laryngoscopes. There is minimum emphasis on more invasive techniques. Traditional methods of instruction continue to be utilized more frequently than nontraditional methods.