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eﬀectiDiﬃcult Airway Management Simulator-Training ModelKyoto University Hospital

Case:General Clinical Education & Training CenterWEB

http://www.kuhp.kyoto-u.ac.jp/Target

Goal

Nurses in the hospital

All nurses in the hospital understand intubation
including the medical devices required and themedicine which may be introduced.

Instructors

Number of Trainees

1 main instructor
5 assistants

Around 10-20
2-3 trainees per group

Why did they start the training?
The hospital found some nurses could not assist theintubation properly because their knowledge on
intubation vary according to experiences. It is
critical all the nurses are available for intubation
assistance especially at the short-staﬀed situation
like the night time.

ITEMS TO PREPARE

Layout example□ Diﬃcult Airway Management Simulator-Training Model□ Laryngoscope□ Intubation tube

□ Stylet□ Lubricant□ Syringe□ Bag valve mask

□ Magill forceps□ Bite block□ Stethoscope□ Adhesive tapeOn the table
DAM
training
model

Medical devices-Prepare 1 set per 2-3 trainees

TRAINING TRICKSINTPOLet them try it without the explanation.
It is important not to teach trainees from thebeginning, for let them integrate the skills andknowledge that they already have.
Trainees will lose initiative and stop thinking if
opportunity of working it out by themselves is notgiven. When the trainees are puzzled, ask questions
that lead them to the solution step by step.

INT

PO

Let’s makechange thetrainees’ atti
from “I willtu
wait until someone els deteaches mee” to “I will learn by myself ”.

Organizing a team of instructors
A specialist of the ﬁeld is required as a maininstructor. In Kyoto University, volunteer medical
students also cooperate. Student members of theCPR training club and paramedic act as assistants.
When the trainees face diﬃculties, they can ask
advice for the instructor team. For the assistant
instructors, it is also an ideal opportunity forlearning; they can obtain knowledge and skills
through by teaching and advising others.

CARRYING OUT THE TRAINING
The below example is for one hour of training session.

Understand the medicines
and its usage

INTPOShow the role-playing of the situation of intubation
and ask questions to trainees.

In the review session, make surethat trainees understand themedicine and the patient’s
condition as a set.
r puncture are

1. The patient suﬀers and cannot keep still.
(The instructor plays as the patient and keep screaming.)

Review
the knowledge

20
min.

Q: What do you do in this situation?

A: Introduce a sedative.

Review the variation of the sedatives and thedose.
●
2. The patient’s chin is stiﬀ and the mouth opening is diﬃcult.
(The instructor plays that he or she cannot move the chin and mouth of DAM simulator. )reviewed.

●Q: What do you do in this situation?

A: Introduce a muscle relaxant.

Verify the variation of muscle relaxants and the dose.

Preparation of themedical devices

10min.

Prepare a variety of medical devices to allow
the trainees choose the right devices
required for intubation.
Explain each device one by one while letthem think the usage and the role of thesedevices.
INT

Let the trainees pick up the devices.

PO

1. Sniﬃng position-When necessary, insert a pillow under thehead.

2. Insertion of the tube
Intubation training

25min.

-Once insertion is done, check the placementof the tracheal tube with the stethoscope.
-Complication such as unilateral ventilationand the esophagus intubation can besimulated.

3. Fixation of the tube
-Fix the tube to the corner of the mouth withtape.

Summary

5
min.

INT

PO

Training in 2-3 trainees
In the training session, maketraiees take turns of the roles ofthe performer and the assistantof intubation. Performing
intubation on the manikin by
him/herself makes a signiﬁcantdiﬀerences in learning how toprovide timely and appropriate
assistance. (Performing intubation is not allowed for nurses inJapan basically.)

Review the main points of the training.
Share and ﬁnd a solution to the questions
from the trainees.

KYOTOKAGAKUHEAD OFFICE & FACTORIES
15 Kitanekoya-cho, Fushimi-ku,
Kyoto 612-8388, JAPANTEL: +81-75-605-2510
FAX: +81-75-605-2519

KYOTOKAGAKU MEM TRAINING CENTRE
Second ﬂ. NREG Hongo-3-chome bldg.,
3-26-6 Hongo, Bunkyo-ku, Tokyo 113-0033,
JAPAN

KYOTOKAGAKU AMERICA INC.
North and South American regions

3109 Lomita Boulevard, Torrance, CA 90505-5108, USA
TEL: 1-310-325-8860
FAX: 1-310-325-8867

2017. 3