%0 Journal Article
%T An Audit of Fibreoptic Intubation Training Opportunities in a UK Teaching Hospital
%A M. D. Wiles
%A R. A. McCahon
%A J. A. M. Armstrong
%J Journal of Anesthesiology
%D 2014
%R 10.1155/2014/703820
%X Airway management is the foundation upon which anaesthesia is built, and fibreoptic intubation (FOI) is a key facet of this skill. Despite this, many trainee anaesthetists in the UK have been unable to perform sufficient FOIs to gain competence. We aimed to establish the incidence of FOI in adult patients, in a UK teaching hospital, in order to determine what FOI training opportunities actually exist. During the study period (from October 1st, 2008, to September 30th, 2009) an estimated 11£¿712 general anaesthetics were undertaken that necessitated tracheal intubation. In 141 of these cases FOIs were performed giving an incidence of FOI of 1.2% (95% confidence interval 1%¨C1.4%). Of these, 86 (61%) were in awake and 55 (39%) in anaesthetised patients. Only 16 (11%) of the FOIs were done solely for the purposes of training. We suggest that a greater number of FOIs should be undertaken to allow trainees to gain and consultants to maintain the FOI expertise necessary for the provision of safe anaesthesia. 1. Introduction Airway management is the foundation upon which anaesthesia is built. Fibreoptic intubation (FOI) is a key part of this skill and forms the basis of the management of many difficult intubations, both anticipated and unexpected [1¨C3]. Accordingly, the National Confidential Enquiry into Peri-operative Deaths (NCEPOD) [4] recommended that every hospital should have anaesthetists trained in FOI. Furthermore, competence in FOI is considered to be an essential part of the training of anaesthetists in the UK. Despite this, many trainee anaesthetists in the UK complete their training having been unable to perform enough FOIs in order to gain competence [5, 6]. The situation is likely to be compounded by the time constraints presented by Modernising Medical Careers and the European Working Time Directive. Training opportunities are likely to be reduced [7] which may make competence at FOI even more difficult to achieve and maintain. The incidence of FOI varies greatly between countries. In Canada, FOIs make up 1.4% of all tracheal intubations [8], whilst in Switzerland the rate is in excess of 12% [9, 10]. To our knowledge, the incidence of FOI within the UK has never been determined. Therefore, we aimed to establish the incidence of FOI in adult patients in a tertiary centre for maxillofacial, ENT, and spinal surgery in order to determine what FOI training opportunities actually exist. 2. Methods Guidance from the National Research Ethics Service (NRES) classified the project as service evaluation, meaning that formal ethical approval was
%U http://www.hindawi.com/journals/jan/2014/703820/