Retention of skills during emergency airway management training: a 12-month follow-up

Introduction

Besides the gold standard endotracheal tube, supraglottic airway devices are alternatives for emergency airway management [1]. The goal of the study was to identify airway devices that provide successful ventilation, even 12 months after training in manikins.

Methods

In 2008, 288 medical students were trained to use laryngeal mask airways (LMAs) Unique, ProSeal, Supreme, I-Gel and bag-mask ventilation (BM) on manikins (Ambu). Students successful on the first attempt (n = 190) for all devices in random order were included and tested 12 months later without further training. The insertion time to first successful ventilation, tidal volume (TV) and gastric inflation were assessed.

Results

The time (in seconds) needed for the I-Gel and the Unique was significant longer in 2009 (BM 2008 8.2 ± 4.7 vs 2009 8.4 ± 5.4, P = 0.882; I-Gel 2008 10.2 ± 2.7 vs 2009 11.7 ± 4.9; P = 0.008; Supreme 2008 15 ± 3.7 vs 2009 15.5 ± 4.6, P = 0.147; Unique 2008 16.5 ± 3.6 vs 2009 18.2 ± 5.5; P = < 0.001; ProSeal 2008 17.7 ± 4.9 vs 2009 17.7 ± 5.2, P = 0.856). A higher rate of gastric inflation for BM and the I-Gel was seen in comparison of 2008 with 2009 (BM 10.5% vs 18.6%, P = 0.012; I-Gel 0.5% vs 4.2%, P = 0.039; Supreme 0.5% vs 2.2%, P = 0.375; Unique 3.7% vs 5.8%, P = 0.607; ProSeal 4.7% vs 1.2%, P = 0,18). About 60% of the TVs were insufficient with little improvement for the Supreme and Proseal (Figure 1).

Figure 1

Tidal volume (correct range 0.4 to 0.6 l).

Conclusions

One year after training, time for successful ventilation for all devices was lower than 25 seconds. This is acceptable compared with the gold standard endotracheal tube, but due to the rising gastric inflation rate and high amount of insufficient tidal volume, shorter intervals of training maybe necessary.