Airway Management Skills Amongst Anesthesia Providers

Overview

The aim of this study is to evaluate the efficiency and proficiency of three common airway management techniques amongst among anesthesia providers who maintain airway management privileges in our health system.

Full Title of Study: “The Proficiency and Efficiency of Airway Management Skills Amongst Anesthesia Providers: A Multicenter Baseline Assessment”

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Cross-Sectional
  • Study Primary Completion Date: February 2022

Detailed Description

Airway management may take place in a variety of settings with varying degrees of urgency, ranging from performance for elective operative procedures to life-threatening emergencies. An appropriate psychomotor skill set is needed to perform the procedures utilized for airway management, and the time required to do so may impact patient outcomes. Prolonged periods of apnea and accompanying hypoxia can lead to brain damage or death. This research is designed to evaluate the proficiency of anesthesia providers who are responsible for practicing airway management in hospitals or health systems in the United States, including Anesthesiologists, Certified Registered Nurse Anesthetists, and Anesthesiology Assistants. We are attempting to establish a baseline level of proficiency by quantifying the time it takes to achieve successful airway management and the number of attempts required to do so utilizing a high fidelity manikin programmed to simulate various physiological conditions. This baseline information could then be used to manage the decisions made by hospitals or health systems related to airway management in the future, or to redefine the policies and procedures established for performing these procedures.

Interventions

  • Procedure: Direct Laryngoscopy
    • The participant will perform a direct laryngoscopy on a Laerdal SimMan 3G under healthy conditions and under limited cervical range of motion.
  • Procedure: Laryngeal Mask Airways
    • The participant will perform LMA placement on a Laerdal SimMan 3G under healthy conditions and under full tongue edema.
  • Procedure: Video Laryngoscopy
    • The participant will perform video laryngoscopy on a Laerdal SimMan 3G under healthy conditions and under half tongue edema with pharyngeal obstruction.

Arms, Groups and Cohorts

  • Anesthesiology providers
    • Group will contain anesthesiologists, CRNA and AAs. The type of healthcare professional participating will be recorded along with the years of experience the participant has. Each participants experience will be categorized into three ranges, 0-3 years, 3-10 years, and 10+ years of experience. For further clarification and analysis, the healthcare professional’s normal practice setting will also be recorded including inpatient, outpatient, or hybrid (inpatient and outpatient) settings. All providers will be analyzed together.

Clinical Trial Outcome Measures

Primary Measures

  • Number of Attempts to Achieve Successful Airway Management
    • Time Frame: Immediate Post-Procedure
    • A successful attempt for any of the three procedures will be documented when a participant attaches a bag/valve and attempts a ventilation resulting in the presence of end-tidal carbon dioxide (which will be displayed when the device is properly placed). Failed attempts for any of the three procedures will be documented when a participant attaches a bag/valve device and attempts ventilation for purposes of confirming the presence of end-tidal carbon dioxide (which will not be displayed if the device is improperly placed). Three sequential failed attempts will result in a failure to achieve successful airway management.
  • Time Required to Achieve Successful Airway Management
    • Time Frame: Immediate Post-Procedure
    • Time will be measured manually via stopwatch. Time measurement for all three procedures will begin when the participant picks up the laryngoscope, video laryngoscope, or LMA having signaled his/her intention to begin the procedure. Time measurement will end upon detection of end-tidal carbon dioxide by the mannikin as evidenced on a standard patient monitor connected to the mannikin for this purpose. Time measurement will continue during failed attempts and subsequent efforts to successfully perform the procedure. Time measurement will be stopped upon successful end-tidal carbon dioxide measurement, three sequential failed attempts to perform a procedure, or after a total of five minutes have passed.

Participating in This Clinical Trial

Inclusion Criteria

  • Informed consent is obtained from the participant – Participants are presently employed as an anesthesiologist (previously completed an anesthesiology residency), CRNA or AA at a participating institution – Participants have active airway management privileges with their institution Exclusion Criteria:

  • Participants are not employed by their institution – Refusal of the participant to sign a consent

Gender Eligibility: All

Minimum Age: N/A

Maximum Age: N/A

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Prisma Health-Upstate
  • Collaborator
    • Vanderbilt University
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Robert R. Morgan, MD, Principal Investigator, Prisma Health-Upstate

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