AIRWAY ROTATION
GOALS AND OBJECTIVES
CA 1 Level
DEFINITION
This is a rotation in general operating room at the University of Colorado Hospital with emphasis
on improvement of airway management skills. It is a recognized fact that an anesthesiologist is
one of the most skilled professionals to deal with the airway. It is a goal by the end of this
rotation to have a competent airway expert to would be able to identify and manage a difficult
airway.
CURRICULUM
The CA-1 resident will be able to perform and further explain goals expressed in General
Operating Room Rotation CA-1 with emphasis on the following:
 Have an opportunity to gain experience in management of the patient with pathology of
head and neck. This includes, but not limited to patients with cancer of the upper airway,
sinus disease, congenital and acquired abnormalities of the airway, and anesthesia for
procedures involving a “shared airway”.
 Familiarize yourself with instruments used for the management of the difficult airway
and increase the level of expertise and confidence in their use.
It is understood that learning to manage airway is on-going process, with continual learning and
improvement during all rotations. However, during this rotation the resident can focus on
improving these skills.
MEDICAL KNOWLEDGE
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Understand and explain the anatomy (including innervations) of the human airway
Understand what factors and disease states contribute to making an airway “difficult”
Identify risk factors for potential difficult mask ventilation
Understand ASA algorithm for difficult airway management and be able to explain the
primary decision point and options for management, including but not limited to
o Oral airway
o Nasal airway
o Various LMAs
o Eschmann Stylet
o Glide Scope
o C-MAC
o Fiberoptic assisted intubation (both in asleep and awake patients)
o Trastracheal jet ventilation
o Retrograde wire
o Cricothyroidotomy
Explain contraindications for the following techniques to improve ventilation:
o Nasal airway
o Oral airway
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o LMA
o Transtracheal jet ventilation
Explain contraindications to the following techniques or aides to securing the airway
o Direct laryngoscopy
o Blind nasal intubation
o Eschmann Stylet
o Fiberoptic assisted
o Intubating LMA
o Retrograde wire
o Cricothyroidotomy
Understand the risks of “shared airway” including airway fire, inadequate ventilation and
loss of airway, and various approaches to prevent complications
Discuss the indications and contraindications to nasal airway manipulations
Understand the complications of airway manipulation
PATIENT CARE
Knowledge units:
 Develop the ability to effectively form and carry out a plan for an expected difficult
airway case
 Develop the ability to effectively form and carry out a plan for airway management
during airway surgery
 Formulate a plan for dealing with unrecognized difficult airway
 Formulate rational plan for the post operative management of a patient who has a difficult
airway
Skills Units:
 Secure airways, with the least possible number of attempts (one time being a goal)
 Be able to perform airway blocks, and discuss possible complications
 Identify the contents of Difficult Airway Cart and be able to locate them rapidly
INTERPERSONAL AND COMMUNICATION SKILLS
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Develop the ability to effectively communicate an airway management plan to a patient
in a manner that reassures the patient, and helps motivate their involvement in the
management of their airway
Develop the ability to effectively communicate an airway management plan to a nursing
staff and surgeons, including eliciting their help if necessary
PROFESSIONALISM
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Demonstrate care and compassion for the patients, and responsiveness to patient’s and
family questions, issues and concerns regarding airway and anesthesia management of
the case
PRACTICE-BASED LEARNING
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Actively pursue current evidence to apply to cases of difficult airway management
Examine and assess experiences for ways to improve patient care
SYSTEMS BASED PRACTICE
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Understand the costs associated with airway equipment management and practice
appropriate resource allocation
Instructional Methods:
 Assignments to cases in which where is known or suspected pathology of the head and
neck, primarily on the ENT and bariatric cases.
 Use of airway adjuncts to facilitate intubation will be encouraged whenever possible
 Working under premise that these skills are best learned under controlled (non-emergent)
circumstances, these airway adjuncts may be used on patients without airway pathology
in order to prepare for a true emergency situations
 Daily feedback and intraoperative teaching on topics related to goals and objectives of
the rotation. Residents will be responsible for reading of the assigned material and
engaging faculty in discussions regarding airway management
 Reading material will be extracted from various textbooks, landmark articles and
any other articles deemed as interesting and helpful in advancement of the airway
skills and knowledge improvement by the faculty of the day
Assessment Tools:
 Residents will be assessed at the end of the rotation by the faculty
 If possible, simulator assessment within the short time of the completion of the rotation
 Residents should complete an evaluation of the rotation and return it to the rotation
director. Suggestions for improvement will be welcomed and encouraged.
Rev. 10/2009
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