CCT in Anaesthetics - Intermediate Level Training

Published: 05/09/2019

Airway Management

Intermediate level competencies and learning outcomes are included in this section specifically relating to airway skills; most will also appear in the ENT, Maxillo-facial and dental unit of training. It is expected that trainees will complete this unit of training over the course of ST years 3 and 4 of training

Learning outcomes:

  • Build on the knowledge and skills gained in the Basic Level airway training
  • Develop knowledge, skills and experience of safe airway management in more complex cases undergoing major elective and emergency surgery including fibreoptic intubation
  • To be able to recognise the specific problems encountered with the airway

Core clinical learning outcome:

  • To be able to demonstrate the ability to perform elective fibreoptic intubation, either for an awake or an anaesthetised patient, with local supervision

NB: All competencies annotated with the letter ‘E’ can be examined in any of the components of the Final examination identified in the FRCA examination blueprint section.

Knowledge

Competence

Description

Assessment

Methods

GMP

AM_IK_01

Lists  the risks associated with awake fibreoptic endotracheal intubation and describe the process of obtaining consent for this procedure

A,C,E

1

AM_IK-02

Discusses the identification and assessment of pathology in or around the airway, including

  • History and examination
  • Anaesthetic chart review
  • Interpretation of investigations such as lateral C-spine X-ray, cross sectional imaging of the upper airway (MRI/CT), flow volume loops 
  • Discussion with surgeons

A,C,E

1,2

AM_IK_03

Outlines the anaesthetic management of potential threats to the airway, including 

  • external compression
  • Foreign body, blood clots, masses
  • Inhalational injury, inflammation
  • Blunt and penetrating trauma

[Cross Ref; ENT]

A,C,E

1

AM_IK_04

Lists the indications for tracheostomy [Cross Ref; ENT]

A,C,E

1,2

AM_IK_05

Outlines the anaesthetic principles for tracheostomy [Cross Ref  ENT]

A,C,E

1,2

AM_IK_06

Describes the management of the obstructed/misplaced tracheostomy

A,C,E

1,2

AM_IK_07

Describes the specialised airway techniques used for laser surgery in, or near, the airway [Cross Ref; ENT]

A,C,E

1

AM_IK_08

Describes the causes, pathophysiology and management of obstructive sleep apnoea and the surgical procedures used to treat it [Cross Ref; ENT]

A,C,E

1,2

AM_IK_09

Outline appropriate follow up of an unexpected difficult intubation

A,C,E

1

AM_IK_10

Discuss the risks and benefits of using  various supraglottic airways for IPPV

A,C,E

1

AM_IK_11

Describes the airway management of a patient undergoing  one-lung ventilation and anaesthesia, including placement of double lumen endobronchial tubes and bronchial blockers [Cross Ref; cardiothorcics]

A,C,E

1

AM_IK_12

Describes the safe use of equipment and airways devices used for surgery on and below the vocal chords, including bronchoscopes, Venturi devices and fibre-optic scopes [Cross Ref; ENT]

A,C,E

1,2

AM_IK_13

Describes the principles of jet ventilation [Cross Ref; ENT]

A,C,E

1

AM_IK_14

Recalls the principles underlying the use of helium [Cross Ref; ENT]

A,C,E

1

Skills

Competence

Description

Assessment

Methods

GMP

AM_IS_01

Demonstrates elective fibreoptic intubation under anaesthesia with or without LMAs or other airway adjuncts

A,D

1,2

AM_IS_02

Demonstrates effective teaching of basic airway manoeuvres, direct laryngoscopy and endotracheal intubation to novice students    [e.g. nurses, CT1 anaesthetic trainees, paramedics, medical students]

A,D

1,2

AM_IS_03

Demonstrate the use of supraglottic airways for IPPV

A,D

1,2

AM_IS_04

Demonstrate double lumen endo bronchial tube placement and lung isolation, including the use of bronchial blockers and the use of clinical/endoscopic methods to confirm correct position [Cross Ref;cardiothoracic]

A,D

1,2