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Training experts in difficult airway management: Evaluation of a continuous professional development program - 07/06/16

Doi : 10.1016/j.accpm.2015.09.005 
Laurent Brisard a, Didier Péan a, Jean-Louis Bourgain b, Arnaud Winer c, Xavier Combes d, Olivier Langeron e, Marc Fischler f, Corinne Lejus a,
a Service d’anesthésie et de réanimation chirurgicale, Hôtel-Dieu – hôpital Mère–Enfant, CHU de Nantes, place Alexis-Ricordeau, 44093 Nantes cedex 01, France 
b Service d’anesthésie-réanimation, institut Gustave-Roussy, 94800 Villejuif, France 
c Réanimation polyvalente, groupe hospitalier Sud Réunion, centre hospitalier Saint-Pierre, Saint-Pierre, Reunion 
d Samu 974, département des urgences, centre hospitalier Felix-Guyon, Saint-Denis, Reunion 
e Service d’anesthésie et de réanimation chirurgicale, groupe hospitalier Pitié-Salpêtrière, AP–HP, 47-83, boulevard de l’Hôpital, 75651 Paris, France 
f Service d’anesthésie et de réanimation chirurgicale, hôpital Foch, 40, rue Worth, 91251 Suresnes, France 

Corresponding author.

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Abstract

Objective

The Formation de référents aux techniques d’intubation difficile (FRTID) is a French continuing medical education program on difficult airway management. Its objectives are to train experts in the task of training other physicians in their hospitals for better guideline compliance. Our aim was to describe the curriculum of the experts and to evaluate the program's efficacy via a prospective survey.

Methods

Each participant was asked to complete a questionnaire before (T0), immediately (T1), 6 (T6) and 12 (T12) months after the course. The main criterion was the proportion of the participants who declared that they had implemented at least one action to improve difficult airway management in their institution at 6 months. Other criteria included the proportion of participants who declared that they had modified their own clinical practice and the frequency of use of specific devices assessed on modified Likert numerical rating scales.

Results

Two hundred and forty-four participants were included in the survey. One hundred and three, 91 and 62 participants responded to the T1 (immediately after the course), T6 (6 months later) and T12 (12 months later) questionnaires, respectively; 73 physicians (i.e. 30% of all participants and 80% of the survey responders) declared that they had implemented at least one action likely to optimize the management of difficult airways. On the T6 and T12 questionnaires, 91% and 97% of the responders respectively declared that they had changed their clinical practice. The course has resulted in increased use of transtracheal oxygenation with manual devices (Manujet®, Enk®) and Seldinger cricothyroidotomy as well as paediatric difficult airway techniques such as paediatric sized elastic gum and Airtraq™ or fibrescopic intubation under general anaesthesia with spontaneous ventilation (through a laryngeal mask).

Conclusion

These data encourage the training of experts in difficult airways. This curriculum is contributing to the dissemination of the recommendations among a large number of practitioners.

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Keywords : Medical continuing education, Difficult airway management


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 This work was presented in part at the following meetings: Société française d’anesthésie et de réanimation (Sfar) (Paris, September 2010), Société de réanimation de langue française (SRLF) (Paris, January 2012), European Society of Anaesthesiology (ESA) annual meeting (Paris, June 2012), Association for Medical Education in Europe annual meeting (AMEE) (Lyon, August 2012).


© 2015  Société française d'anesthésie et de réanimation (Sfar). Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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