2021 Curriculum learning syllabus: stage 3 special interest areas

Published: 25/02/2021

Anaesthesia for Patients with Complex Airway

  • Group 2: 3 to 6 months

Learning outcomes

  • Provides safe perioperative airway and anaesthetic care for a wide variety of patients with complex airway problems independently
  • Is capable of leading the delivery of care in this area of anaesthetic practice, to the benefit of both patients and the organisation

Key capabilities

A

Is a senior decision maker within the multi-disciplinary team in planning the appropriate airway management in patients with advanced airway pathology

B

Can proficiently manage the difficult paediatric airways that may present in any non-specialist hospital

C

Performs awake and asleep intubation in all patients with advanced airway pathology

D

Can plan and manage at-risk extubation

E

Utilises techniques for apnoeic oxygenation and ventilation

F

Proficient in front of neck access to the airway

G

Is proficient in independently managing anaesthesia for patients needing a wide range of major head and neck surgeries

Examples of evidence

Experience and logbook:
  • pre-operative clinic based assessment and multi-disciplinary planning for the suitability of surgery of patients with complex head and neck pathology like cancer, infection and congenital or acquired anatomical deformities
  • range of experience in theatres including ENT and head and neck surgery and specialist paediatric lists.
Supervised Learning Events (SLEs) can be used to demonstrate:
  • pre-operative assessment and management of complex head and neck surgery patient
  • leadership of multi-disciplinary planning for patients with complex airways
  • practical procedures such as:
  1. video-laryngoscope assisted intubations using both MAC and hyper angulated blades
  2. pre-operative nasendoscopy
  3. awake and asleep fibre-optic intubation
  4. awake bronchoscopies
  5. front of neck access techniques: ultrasound guided, mannequin, cadaver
  6. jet ventilation (tube-less surgeries)
  7. apnoeic oxygenation techniques
  • ability to interpret investigations like CT head & neck and CT chest to aid the planning of complex airway management
  • use of innovative techniques for complex airway management.
Personal Activities and Personal Reflections may include:
  • national and international meetings related to management of complex airways, for example Difficult Airway Society meetings
  • difficult airway training courses
  • presentation at relevant meeting ie abstract or free paper
  • development of guidelines and policies related to airway management
  • leadership of QI projects related to airway management
  • involvement with local/regional educational programs for teaching airway skills
  • leadership training
  • attendance at MDT ENT - radiology teaching sessions.
  • attendance at ENT clinics (nasendoscopy experience)
  • attendance at respiratory bronchoscopy sessions.
Other evidence:
  • satisfactory MSF.

Suggested supervision level

  • 4 - should be able to manage independently with no supervisor involvement (although should inform consultant supervisor as appropriate to local protocols).

Cross links with other domains and capabilities

  • all generic professional domains of learning
  • General Anaesthesia