Course Review: Advanced Airway Management Course Refresher

Beginnings of my difficult airway kit: Melker cricothyrodotomy 4.0 kit, 14G Cannula, 5ml Syringe

I am fresh from the Advanced Airway Management Refresher Course in Melbourne last week. It was an excellent educational event and I couldn’t recommend it more to any doctor involved in airway management. There are a few other courses around Australia which are also run by members of the Australian and New Zealand College of Anaesthetist Special Interest Group in Airway Management.

The course organisers have designed a contemporary curriculum instep with the recent NAP4 findings and sought to give airway doctors confidence in the dreaded can’t intubate, can’t oxygen situation (CICO). They have also acknowledged the rapidly advancing importance of video laryngoscopy in difficult airway management.

There is an anaesthetic focus and the course is heavily populated by anaesthetic registrars, consultants and fellows but there was a fair sprinlking of ED & ICU doctors.

The subtle touches such as an all-day barista (unlimited coffee!), excellent food, great venue and enthusiastic faculty made this $900 well spent.

The day consisted of four main areas with practical stations:

CICO -> Dr. Andy Heard gave an excellent lecture outlining a clear and simple approach, why this approach works, their experience from the wet lab in over 3000 CICO scenarios!. The techniques described were a 14G Cannula and Scalpel/bougie approach which we were able to practice on models. This is a link to a series of extremely useful videos produced by Andy on Youtube.

Simulation session -> 8 scenarios run in excellent facilities with realistic tension and equipment. Each participant took park in an individual CICO scenario with an airway nurse and senior registrar!

Video Laryngoscope session -> Short and sharp lecture on how, what and why we use these, the increasing evidence behind its use and common issues faced. The VL’s presented and available to use were Glidescope, Mcgrath, King vision, Storz CMAC and Airtraq. My favourite for institutional use is the Storz Cmac but am strongly considering buying the King Vision for my personal anaesthetic kit.

Fiber-optic and airway topicalisation -> All airway doctors should be familiar with the fiberoptic scope and its use even if it doesn’t appear daily in their work. This station was completely hands on and fun! There were great practical tips on how to topicalise an airway and approaches to an awake fiber optic intubation.

So what am I taking away from this course as a GP Anaesthetist?

  1. CICO techniques – what they are, clear algorithm on when to use it, when to move on, developing my own difficult airway kit
  2. Extubation planning – Having a plan is important as this is a high risk time for airway complications.
  3. Solidification of the role of VL’s in modern anaesthetic practice
  4. Topicalisation for AFOI but more pertinent is topicalisation for awake intubation with laryngoscope, have a look with a breathing patient
  5. Networking, learning from others experience!
  6. Introduction to the fiberoptic scope and familiarity of its use if I need to use it

 

So in summary, it is well recommended for GP anaesthetists as it teaches some essential techniques and gives you an opportunity to ask heaps of questions from the best airway people in the country!

Scalpel bougie technique

 

 

 

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