FORMAL INSTRUCTION IN DIFFICULT AIRWAY MANAGEMENT - A SURVEY OF ANESTHESIOLOGY RESIDENCY PROGRAMS

Background: Up to 30% of all deaths attributable to anesthesia are rel ated to difficulties with airway management. The purpose of this study was to determine whether anesthesiology residents are receiving speci alized Instruction in the various techniques and mechanical devices cu rrently recommended for airway management in patients with anticipated or unanticipated difficult airways. Methods: A single anonymous quest ionnaire about resident instruction in the area of difficult airway ma nagement was mailed to the directors of 169 American anesthesiology pr ograms. Results: Twenty-seven percent of the 143 programs from which t here were responses require residents to participate in a rotation ded icated to management of the difficult airway. As they currently exist, rotations tend to be of short duration. Many are limited to lectures only and infrequently employ state-of-the-art teaching systems. In som e programs, recognized airway management techniques such as the Bullar d laryngoscope and esophageal-tracheal combitube are not taught at all . Conclusions: Based on the data obtained by the authors, formal instr uction in difficult airway management is not offered by most residency programs. It is commonly taught as difficult clinical situations aris e. Because these difficulties occur sporadically, opportunities for te aching are occasional. Learning based on sporadic and occasional occur rences risks incomplete and nonuniform training of residents.