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Simulated Angioedema in a Fresh Frozen Cadaver: A Novel Teaching Model for Airway Training
Ryan M Walsh1, Jason D Bothwell
1From the Department of Emergency Medicine, Madigan Army Medical Center, Tacoma, WA.
Introduction:
As educators, we are charged with preparing emergency medicine residents for successfully intubating patients with even the most troublesome anatomy. This situation is encountered during the intubation of patients with angioedema. These patients are uncommon in the emergency department, and as a result, it is difficult to ensure that each resident is well trained in this intubation scenario before graduation.
Educational Objective:
Our goal was to develop an angioedema teaching model to increase resident knowledge, confidence, and proficiency at intubating in this clinical setting.
Curricular Design:
Using a 22-gauge spinal needle and a 60-mL syringe, we were able to cause realistic distention of the lips, tongue, and pharynx when we injected approximately 300-mL of air bilaterally near the sublingual glands and into the tongue and lips. Before implementing the angioedema model into the curriculum, 5 board-certified attending emergency physicians evaluated the model for validation, and all agreed that it was high fidelity.Participants performed both direct and video laryngoscopy on the simulated angioedema cadaver. At the conclusion of their intubation experience, the participants completed a survey describing their impression of the angioedema model.
Impact/Effectiveness:
Participants included 29 emergency medicine residents, with participants from all year groups. In response to the statement, "The angioedema model was high fidelity," 12 residents strongly agreed, whereas the remaining respondents agreed. In response to the statement, "The angioedema model was a good training model for angioedema," 13 residents strongly agreed, whereas the remaining respondents agreed. When solicited for comments on the model, one participant wrote, "Awesome opportunity, I will be markedly less terrified when I get an angioedema/anaphylaxis case."We have developed an angioedema training model using air insufflation in a fresh frozen cadaver. Our participants uniformly expressed positive impressions of both the fidelity and training quality of this model.
