Airway Emergency Drill: An In Situ Simulation to Increase Staff Preparedness for Airway Bleeding

In situ simulation offers a valuable opportunity for teams to refine emergency response skills within their actual clinical environment. To evaluate the efficacy and utility of this model, we implemented an in situ emergency airway drill simulation on the otolaryngology inpatient floor at a quaternary care hospital and assessed participant-reported outcomes. Twelve in situ airway emergency simulations were conducted over 3 years, involving 63 Airway Rapid Response Team (ARRT) otolaryngologists, anesthesiologists, respiratory therapists, surgical intensivists, nurses, and pharmacists. Emergency scenarios simulated real-world airway crises. Surveys assessed provider confidence, anxiety reduction, subjective value of the experience, and perceived impact on patient safety. Confidence ratings were collected pre- and post-simulation in a subset of 34 participants and analyzed via paired t-test. Qualitative feedback from debriefing sessions was thematically assessed. Post-simulation surveys demonstrated 72% of participants reported increased confidence in airway emergencies, and 86% reported reduced anxiety compared to before the simulation. It was also found that 93% of participants valued the experience, and 100% agreed that the in situ drill will positively impact patient safety. Confidence increased significantly among participants who completed pre- and post-simulation assessments (5.8-7.6 on a 10-point scale; p < 0.0001). Qualitative themes highlighted increased familiarity with airway equipment and improved interdisciplinary communication, with 56% of participants independently citing these as main takeaways. In situ airway emergency drills are an effective tool for training multidisciplinary teams, as they improve provider confidence, familiarity with equipment, and interprofessional collaboration in preparation for high-stakes airway emergencies. N/A.