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14.12.2018 | Original Article | Ausgabe 3/2019

Irish Journal of Medical Science (1971 -) 3/2019

Achieving proficiency in rigid bronchoscopy—a study in manikins

Zeitschrift:
Irish Journal of Medical Science (1971 -) > Ausgabe 3/2019
Autoren:
Jonathan Royds, Muiris A Buckley, Mark D Campbell, Grace M. Donnelly, Michael F.M. James, Roisin Ní Mhuircheartaigh, Conan L McCaul
Wichtige Hinweise
This data has been presented in part at the World Airway Management Meeting in Dublin in November 2015.

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Abstract

Background

Rigid bronchoscopy may be used to relieve acute airway obstruction following induction of anaesthesia and is a recommended option for management of the difficult airway. The ability of anaesthetists to perform rigid bronchoscopy has not been reported. We sought to explore the acquisition of procedural skill in rigid bronchoscopy by anaesthesiologists in a manikin.

Methods

In a prospective interventional study, participants were asked to perform 40 rigid bronchoscopies in a TruCorp AirSim Advance airway manikin, configured to a randomised sequence of easy or difficult laryngoscopic grades to which the participants were blinded. The primary outcome was stabilisation (the attempt after which no further reduction in procedural time occurred). Dental injury and oesophageal intubation were also recorded. Forty anaesthesiologists and 40 unskilled controls (without laryngoscopic skills) participated.

Results

In the easy model, stabilisation occurred at attempt 8 in the anaesthesiology group and 10 in the unskilled controls. In the difficult model, stabilisation occurred at attempt 10 in both groups. Dental injury was less common in the anaesthesiology group. The proportion of participants achieving procedural competency did not differ between groups in either the easy (35/40 vs. 30/40) or difficult model (32/40 vs. 25/40).

Conclusions

This study shows that the technical skill of rigid bronchoscopy can be acquired within 10 repetitions in a manikin model. As procedural competence and complication frequency vary with the laryngoscopic grade of the model, both easy and difficult configurations should be used for training. Advanced laryngoscopic skills are not required prior to training in this technique.

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