Advanced Airway Management Skill Decay: A Review of the Literature

Anesthesia providers must be experts in advanced airway management techniques such as laryngeal mask airway and endotracheal tube insertion. However, practicing anesthesia providers may work in clinical settings where advanced airway management techniques are rarely required. Infrequent advanced airway skill performance in these clinical settings can lead to skill decay, which is the gradual loss of acquired skills through infrequent practice or extended periods of skill nonuse. This literature review synthesizes available evidence regarding advanced airway management skill decay. Themes emerging from the literature review include skill decay association with decreased endotracheal intubation success rates, a timeframe within which advanced airway management skill decay may begin to occur, and recommendations for preventing decay of advanced airway management skills. With infrequent use of advanced airway skills in clinical settings, routine practice is crucial for skill maintenance. Clinical simulation could play a role in mitigating skill decay among practicing anesthesia providers at risk for decay in advanced airway management skills resulting from skill nonpractice.