Medicina y Cirugía Oral y Maxilofacial: Medicina y Cirugía Oral y Maxilofacial



How to arrange and conduct a successful CME event on airway management

Tanmay Tiwari1, Prem Raj Singh1, Tanya Tripathi2


Medicine is an ever-evolving branch of science, which requires regular teaching and training for the core purpose of patient safety. Physicians around the world are attending newer courses, workshops and continuing medical education (CME) programs to enhance their individual clinical skills. These courses offer much beyond the didactic lectures and are now routinely recommended by the regulatory authorities of most of the countries. This article will provide in-depth information for the conceptualization, planning and conduct of any educational medical course with a special reference to airway management. Key words: Accreditation, Airway, Anesthesiologists, Education, Physicians, Continuing medical education-

1Associate Professor, Department of Anesthesiology, King George’s Medical University, Lucknow, (India) 2Resident, Department of Pathology, Era Lucknow Medical College, Lucknow, (India) Correspondence: Dr. Tanmay Tiwari Assistant Professor Department of Anesthesia & Critical Care King George’s Medical University, Lucknow, (India) Email: Phone: +91-9452526270 Received: 26 August 2019, Reviewed: 29 August, 7 September 2019, Revised: 4 September 2019, Accepted: 14 September 2019

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PREPARATION Academic program preparation: Academic or scientific schedule is the actual soul of the CME and workshop, therefore it should be attractive, with hot topics and with renowned speakers. Academic schedule for the course is decided by a core group of organizing team, comprising of senior anesthesiologists with sufficient teaching and working experience in the field of anesthesia. Academic schedule is usually divided into thematic sessions; Morning session of about 4 hours should comprise of keynote lectures, ‘how-I-do-it’ problem based case discussion, video session showing different approaches to airway management using various gadgets and techniques, and Afternoon session of 4 hours including hands on workshop on various workstations. Keynote lectures are allotted to senior academicians who have extensive experience in the field of airway management. These lectures should cover topics like ‘Airway Assessment- Current Status’, ‘Difficult Airway Guidelines’, ‘Ultrasonography (USG) of Airway’, Apneic Óxygenation’, and ; Extubation of Difficult Airway’. ‘How-I-do-it’ – Problem based case discussions are short case based scenarios of difficult airway; on topics which include airway management in morbidly obese, burns, pediatric cleft lip palate, head and neck trauma, temporo-mandibular joint ankylosis, upper airway malignancy, and pregnancy. For this session practical approaches to particular cases are discussed with special take home message content. The final session before lunch may be planned as a video session which showcases the tricks and special paper 320 ANAESTH, PAIN & INTENSIVE CARE; VOL 23(3) AUGUST 2019 techniques of multiple alternative approaches to difficult intubation like submental intubation, retrograde intubation, lightwand assisted intubation, blind awake nasotracheal intubation, percutaneous cricothyroidotomy and awake fiberoptic intubation. Post lunch afternoon session of the course may be planned for the interactive hands on workshops for participants at multiple workstations. Workstations (Table 1) provide an opportunity to the participants to be acquainted with different options available for airway management, from easier to the most difficult scenario, according to the Guidelines of Difficult Airway Society (DAS). The total duration of the CME + workshop may be from 0900 hours to 1800 hours in the evening (Total content hours of 8 hours + 1 hour break) in a day. Guest Faculty: We must aim to complete the scientific agenda with confirmed speakers. All official invites to the respective faculty members are sent 45 days before the course, so that they have ample time to prepare their talks. Faculty for the course may be selected from the host institution or other reputed national institutions. Some visiting international faculty can be an advantage. All the faculty are reminded from time to time and are requested to strictly comply with their allotted time for the talks. To avoid lapse in the program, few potential faculty from the organizing committee itself are kept in reserve and are asked to prepare a topic to be presented in case of failure of an invited faculty to attend the event. Announcement & Delegate Registration: A successful academic course or workshop requires a decent number of participants. Endorsement by professional bodies can be helpful, but dissemination of an impactful poster or brochure with original content of scientific agenda with renowned speakers on all available venues is required. To get maximum participation, details of the course need to be widely circulated in nearby hospitals, medical colleges and institutions using both print and electronic media. The course is also publicized through institutional website and electronic media through e-mails and WhatsApp messenger. The announcement posters must clearly mention essential information for the participants as given in Box 1. Box 1: Desirable information in announcement posters 1. The host institution 2. Title of the event 3. Venue 4. Day, dates and timings 5. Course director 6. National / local faculty 7. International faculty 8. Objectives 9. Who should attend 10. CME credits 11. Course program 12. Registration details; Fee; Bank account details special paper Table 1: Hands-on workstations and equipment required Workstation Equipment Workstation 1: Basic face mask techniques Face masks, Assorted types and sizes; Guedal oropharyngeal airway; Nasopharyngeal airway; Ambu bag; Airway manikin; Gel Workstation 2: Supraglottic airway (SGA or SGD) I-gel; Air-Q; LMA Classic; LMA Proseal; FasTrach,or the LMA Supreme. The LMA Unique; Combitube; Laryngeal tube; Airway manikin; Gel Workstation 3: Intubation; routine Endotracheal tubes, assorted sizes; McGill Laryngoscope handle, adult, pediatric; Macintosh laryngoscope blade, assorted sizes; Miller blade, assorted sizes; McCoy blades, two sizes; Intubation trainer manikin; Gel Workstation 4: Intubation; Difficult Endotracheal tubes, assorted sizes; Video laryngoscopes (rigid) VividTrac®, King Vision®, V-Mac® (Storz), C-Mac®, GlideScope®, McGrath MAC®, Pentax-Airway Scope® Airtraq®, Bonfils®, Bullard® laryngoscope, Ambu A-scope® ETView®, TruView®, Trachlight®, Shikani® Intubation trainer manikin; Gel Workstation 5: Intubation; Difficult Endotracheal tubes, assorted sizes; Flexible fiberoptic bronchoscope, adult, pediatric; Berman and Ovassapian airways; Intubation trainer manikin; Gel Workstation 6: Surgical airway Cricothyroidotomy set; Cricothyroidotom

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