Anaesthesia trainees exposure to airway management in a tertiary adult teaching hospital

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Clarke RC, Gardner AI
Department of Anaesthesia, Sir Charles Gairdner Hospital, Western Australia

Purpose of Study

Changes in anaesthetic work practice and industrial conditions have reduced the time trainees spend in clinical anaesthesia1. The purpose of this study was to estimate the exposure in airway management by a trainee gained in a tertiary adult teaching hospital.

Methods

Schedules for operating theatres and other anaesthetising locations at our hospital were obtained for twenty consecutive weeks from 1 January 2006. Anaesthesia records for all patients were obtained and reviewed, and from these the following data were obtained: the presence of a trainee, the type of airway used (if the patient was not intubated before arrival), the grade of the laryngoscopic view, and the use of non-standard laryngoscopy for intubation.

The number of airway procedures was divided by the number of trainees attached to the department, and extrapolated to give a yearly estimate of airway procedures per trainee.

Results: There were 28 trainees (all full time) in the department over the study period. The results are attached in table 1.

Conclusion:  Our results suggest that airway management exposure is not extensive.  Although we did not have a previous study with which to compare our data, our number is less than that reported in another training jurisdiction2. Although competency is difficult to assess, it may be that this data has implications for training, unsupervised practice, and rostering.  Experience in certain airway skills may need to be supplemented using techniques such as simulation.

1. Chan SL, Gardner AI. A Comparison of Working Hours of WA Anaesthetic Training Scheme Registrars between 1996 and 2006.

2. Whymark C, Moores A, MacLeod AD. A Scottish National Prospective Study of airway management skills in new-start SHOs. British Journal of Anaesthesia 2006; 97(4): 473-5.

Table 1

Trainees’ (n=28) exposure to airway management in a tertiary teaching hospital