Achieving proficiency in rigid bronchoscopy-a study in manikins.

Area of Science:

• Medical Education
• Anesthesiology
• Airway Management

Background:

• Rigid bronchoscopy is crucial for acute airway obstruction and difficult airway management.
• The proficiency of anesthesiologists in performing rigid bronchoscopy is not well-documented.
• This study investigates skill acquisition in rigid bronchoscopy among anesthesiologists using a manikin model.

Purpose of the Study:

• To evaluate the learning curve for rigid bronchoscopy among anesthesiologists.
• To compare skill acquisition in easy versus difficult airway manikin models.
• To assess the impact of prior laryngoscopic skill on rigid bronchoscopy training.

Main Methods:

• Prospective interventional study involving 40 anesthesiologists and 40 unskilled controls.
• Participants performed 40 rigid bronchoscopies on an airway manikin with randomized easy/difficult configurations.
• Outcomes included procedural time stabilization, dental injury, and esophageal intubation.

Main Results:

• Stabilization of procedural time occurred by attempt 8 (anesthesiologists) or 10 (controls) in easy models, and by attempt 10 in both groups for difficult models.
• Dental injury rates were lower in the anesthesiology group.
• No significant difference in achieving procedural competency was observed between groups in either model.

Conclusions:

• Technical proficiency in rigid bronchoscopy can be achieved within 10 repetitions in a manikin.
• Training should incorporate both easy and difficult airway scenarios to address varying procedural competence and complication rates.
• Advanced laryngoscopic skills are not a prerequisite for learning rigid bronchoscopy.