Anaesthesia trainees' exposure to airway management in an Australian tertiary adult teaching hospital

The purpose of this study was to estimate the exposure of trainees to airway management techniques in an Australian tertiary adult teaching hospital. Anaesthesia records for all patients over a 20-week period were reviewed and the following data were obtained: the presence of a trainee, the type of airway used, the grade of the laryngoscopic view and the use of non-standard laryngoscopy for intubation. Data was recorded contemporaneously and analysed retrospectively. The data was then extrapolated to give a yearly estimate of airway procedures per trainee. There were 28 full-time trainees in the department over the study period. The estimated mean number of standard intubations performed per trainee per year was 157.4, with 2.9% being grade 3 or 4 laryngoscopies. The estimated mean annual numbers for other airway techniques were: 1.2 fibreoptic intubations, 0.5 mask-only anaesthetics and 3.7 endobronchial double-lumen tubes. Our results suggest that trainees' exposure to airway management techniques is not extensive. As there is no previous study to determine experience gained by trainees, we are unable to establish whether there has been a decrease in experience, however we believe this is likely. Although competency is difficult to assess, it may be that this data has implications for training, unsupervised practice and rostering. Experience in certain airway skills may need to be supplemented using techniques such as simulation.