A Systematic Approach to Airway Evaluations

Objective: To evaluate the baseline knowledge of primary care responders in their assessment and treatment of airway disease and to recommend a detailed protocol for airway evaluations based on objective deficiencies. Methods: A five question survey was distributed to residents of all years of training in the emergency medicine department, internal medicine department, and pediatrics department at Emory University Hospital. The survey was anonymous and each question targeted a specific area in airway diagnosis and management. The average number of answers correct overall, within each group, within each year of training, and for each individual question were analyzed. Results: A total of 64 residents (27 emergency medicine residents, 15 internal medicine residents, and 22 pediatrics residents) at Emory University Hospital participated in our study. The average percent of correct answers for all residents was 82% (84% for emergency medicine, 83% for internal medicine, and 79% for the pediatric residents). Average percent correct for each question for the overall group was: 95%, 98%, 63%, 66%, and 89% respectively. There was no statistical significance between groups of residents. Conclusion: The results of the study indicate that residents were knowledgeable in definitions and classifications of airway obstruction. However, they lacked the necessary knowledge to initiate care and determine which types of scenarios qualify as emergent. Deficiencies were identified and used to create a recommended flow diagram for airway management in terms of history, physical exam, preliminary care, and ability to classify airway consults. Our survey demonstrated the need for resident education in airway evaluation.