The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

IMPLEMENTATION OF AN ADVANCED AIRWAY MANAGEMENT TRAINING PROGRAM WITHIN A MULTI-CENTER HEALTH CARE SYSTEM

Russell E. Graham1, Bobbie Melton1, Joey Wilson1, Adam Mullaly1, Stanley Rhone1, Tracy Green2, Davide Cattano3; 1Respiratory Care, Memorial Hermann - Texas Medical Center, Houston, TX; 2Respiratory Care, Memorial Hermann - The Woodlands, The Woodlands, TX; 3Anesthesiology, University of Texas - Houston, School of Medicine, Houston, TX

Background: Medical literature supports training Respiratory Therapists in placement of advanced airways in urgent/emergent situations when competent physician staff is unavailable or time delayed in arrival (1). Memorial Hermann Healthcare(MHHS), an 11-hospital system, consists of academic and non-academic facilities. The system has level I,II,and III trauma centers. Anesthesia support is not available in-house on a 24/7 basis at all facilities. This identified a need within the system to establish a structured advanced airway management training program. Discussion among Leadership identified an additional need for uniformity of education and training. Method: A task force was established, which included a physician champion, to evaluate available resources and desired educational/training objectives. This task force was charged with the responsibility of planning, organizing, and executing the training program. Results: A comprehensive didactic and simulation training program was established, including objective criteria for successful completion. Training occurs at the system’s Level I trauma center, which is fully equipped with all necessary audiovisual equipment as well as a comprehensive patient simulator (SimMan®, Laerdal Medical, Wappingers Falls NY). The training and evaluation entails 14 hours of didactic instruction, 8 hours of comprehensive training/ simulation, and 6 hours of testing/evaluation. This evaluation includes written and skills demonstration components. Program oversight is provided by a Board Certified Anesthesiologist who is a faculty member. Program instruction is provided entirely by a core of Registered Respiratory Therapists. Candidates who successfully complete the program are then returned to their respective facility for continued practical training in the Operating Room with Attending Anesthesiologists until the required minimum of advanced airway placements is completed. Annual retraining/recertification are also part of the program Discussion: To date, 10 individuals (8 RRT, 2 ACNP) have completed training, and are maintaining >90% success at placement of an advanced airway on the first attempt. No adverse events as a result of airway placement have been noted. These findings complement results found in medical literature. As first responders to “Code” situations in the hospital setting, trained Respiratory Therapists are fully capable of advanced airway management. (1) Respiratory Care 1999, 44(7):750-755 Sponsored Research - None

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