G19(P) A Regional Survey of Paediatric Trainees About Airway Management Skills

Abstract

Background Postgraduate training in paediatrics has moved from time based to competency based learning. Due to the current full shift pattern of working, opportunities available to the individual trainee will vary greatly. One of the critical core competencies expected of all paediatric trainees is the management of the neonatal airway including a difficult airway. Despite this, there is no specific airway management syllabus in the neonatal curriculum published by the RCPCH and no formal focussed training programme for trainees to achieve this competency. Aim To ascertain the competence of paediatric trainees at neonatal airway management. Methods A regional questionnaire survey of paediatric registrars on the middle grade rota between May-Oct 2012 Results A total of 111 paediatric registrars at various stages of training answered the survey. 80% of trainees were NLS providers while 73% were APLS providers. Nearly half had received formal in-service training including theoretical and practical sessions on airway management while 23% trainees had received some formal training in anaesthetics. 41% trainees at ST4-5 level and 5% trainees at ST6-ST8 level had performed less than 20 intubations. 32% trainees had used advanced airway adjuncts ie. laryngeal mask airway (LMA) during training. While majority had used a manikin model to practise neonatal airway management techniques, some had experienced high fidelity simulation and only a handful had the experience of other methods such as e-learning, multimedia, closed circuit television or video laryngoscope. 80% trainees strongly felt a structured training programme would be valuable to them, particularly at an early stage of training. Conclusion Training on neonatal airway management skills is not uniform amongst paediatric trainees. A reduction in training time may result in some trainees failing to achieve basic neonatal airway competencies. Successful completion of life support courses ie, NLS and APLS does not confer mastery in airway management skills. Major changes have to take place in the way training is delivered if quality is to be maintained. A structured programme using a variety of technology enhanced teaching methods including high fidelity simulation is required at commencement of registrar training. This will ensure that future trainees achieve competence in this vital skill.