ICU Emergencies Simulation Curriculum for Critical Care Fellows: The Difficult Airway
Jonathan M. Keller,
Trevor C. Steinbach,
Rosemary Adamson,
David J. Carlbom,
Nicholas J. Johnson,
Jennifer Clark,
Patricia A. Kritek,
Başak Çoruh
Affiliations
Jonathan M. Keller
Fellow, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington School of Medicine
Trevor C. Steinbach
Fellow, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington School of Medicine
Rosemary Adamson
Assistant Professor, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington School of Medicine; Staff Physician, Pulmonary and Critical Care Medicine, Veterans Affairs Puget Sound Health Care System
David J. Carlbom
Associate Professor, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington School of Medicine
Nicholas J. Johnson
Assistant Professor, Department of Emergency Medicine, University of Washington School of Medicine
Jennifer Clark
Respiratory Therapist, Department of Respiratory Therapy, Harborview Medical Center
Patricia A. Kritek
Professor, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington School of Medicine
Başak Çoruh
Assistant Professor, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington School of Medicine
Introduction Management of airway emergencies is a core skill for critical care fellows. There is no standardized training mechanism for difficult airway management among critical care fellowships, although fellows frequently cite management of airway catastrophes as an area of educational need. Methods Three simulation cases that are each approximately 15 minutes in length are presented. The cases represent airway emergencies encountered in the intensive care unit consisting of angioedema, endotracheal tube dislodgement, and endotracheal tube occlusion. Incorporated into the scenarios are planned incidents of interpersonal conflict requiring negotiation by the learner during a crisis event. The case descriptions are complete, with learning objectives and critical actions as well as all necessary personnel briefs and required equipment. Results The cases were completed over multiple simulation sessions on different days by 11 first-year critical care fellows during the 2016–2017 academic year. All participants demonstrated improvement in self-perceived confidence in airway management skills. Discussion The cases were felt to be realistic and beneficial and led to perceived improvement in management of airway emergencies and leadership during crisis scenarios.
