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Airway Management

Airway management is a fundamental skill set required of and practiced daily by every anesthesiologist. Our resident curriculum teaches and reinforces both basic and advanced airway management skills and begins within the very first days of the resident's CA-1 year and progresses through the CA-3 year.

Education

CA-1s have several didactic lectures on basic airway management skills during their CA-1 tutorial followed by a group airway management session in the simulation center. Through this simulation session, CA-1s are exposed to common airway management clinical scenarios and they have an opportunity to practice with several of the advanced airway management tools that are available within the Department. This simulation session is then repeated during their CA-1 year to reinforce many of the airway management scenarios that they have been exposed to clinically as well as to evaluate their progress.

Each CA-1 also participates in a month-long rotation dedicated to airway management. Residents have access to an online syllabus of pertinent airway management articles which they are expected to read over the course of the rotation. They also attend a half-day session in the simulation laboratory becoming familiar with the airway equipment and fiberoptic intubation techniques. The airway day also includes a tour of the hospital and the pertinent airway equipment available in clinical locations outside of the Department (Emergency Department, Intensive Care Unit (ICU), and Pediatric ICU). The second half of the day is spent with Dr. Joseph Paydarfar in the Ear, Nose and Throat (ENT) Cancer Clinic. This is a unique opportunity to work with a skilled ENT surgeon and reinforce knowledge of airway topicalization and scope techniques as well as airway anatomy.

During this rotation, residents receive exposure to many of the airway management tools present in the Department (such as the Glidescope, Bullard Laryngoscope, Aintree Catheter, etc.) in a nonemergent/elective setting. In so doing, residents become prepared to be first responders to airway management calls throughout the hospital

The last component of the CA-1 airway management curriculum is completion of Advanced Trauma Life Support (ATLS). This course exposes the resident to trauma airway management.

CA-3s engage in airway management during a two-week elective. During the elective, they gain intense exposure to difficult airway management cases selected through the pre-admission testing area. Residents are expected to manage these cases in an independent manner with the attending staff physically present for immediate back up and assistance. Many CA-3s appreciate this opportunity to practice and solidify their airway management skills prior to graduating.

An additional component of the CA-3 curriculum is a surgical airway cadaver lab arranged by Dr. Kathleen Chaimberg. At the beginning of the CA-3 year, residents have a one-day wet lab on surgical airway management. The morning is spent practicing cricothyrotomies and retrograde wire placement on a simulator. In the afternoon, they are joined by four staff physicians in the anatomy laboratory at the Geisel School of Medicine at Dartmouth where they practice cricothyrotomies on cadavers. This unique experience allows residents to obtain invasive, emergent airway management skills in a controlled environment.

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