Integrating Sagittal Donor Airway Dissection, Airway Anatomy Landmarks, Sectra 3D Interactive Imaging Table, 7‐Sigma Airway Intubation/Bronchoscope Simulator, Eagle Vision Video Laryngoscope, Glidescope BFlex Bronchoscopy and Sonivate Ultrasound Finger Probe Creating Applied Anatomy and Clinical Skills
Authors: Haddad Michael , Wang Joe , Benninger Brion 
Published: April 2020

INTRODUCTION

Traditionally applied airway anatomy landmarks are not taught separately but assumed as part of pharynx (nasal, oral, larynx) teaching to first year healthcare students. Often minimal airway dissection is conducted to cadavers unless sagittal plane anatomy is achieved. Acquiring proper airway skills is necessary for all providers as it saves lives, however, it is notoriously difficult due to multifactorial parameters of structure orientation, angles, tissue compliance and age variation. Current simulation is unrealistic (except 7‐Sigma) regarding kinesthetic sense of soft tissue and demonstrating recognized landmarks with accurate orientation. Hospitals provide simulation opportunities for airway skills practice but rarely include mixed wet and dry simulation. Objective of this study was to integrate sagittal cadaver dissection with the most current medical technologies revealing actual 3D human airway anatomy while acquiring clinical intubation, bronchoscopy and ultrasound skills with first year medical and physician assistant students.

METHODS

Literature search was conducted to identify multimodal approach to teaching clinical airway anatomy and skills during first year undergraduate medical training. Anatomy texts and atlases were assessed to confirm if recognized clinical airway anatomy landmarks were described separately as a group and/or illustrated as such. Anatomy skills lab included embalmed cadavers for head and neck dissection in the sagittal plane with subsequent sternum and anterior rib cage removal. Airway technology stations with short tutorials included Sectra 3D interactive imaging table, 7‐Sigma airway intubation simulator with lifelike kinesthetic sense, Eagle Vision video laryngoscope, Glidescope Bflex bronchoscopy and Sonivate ultrasound finger probe were set up chronologically to develop applied anatomy and clinical skills.

Literature search revealed no known studies with current multiple airway technologies taught and experienced sequentially in a single setting by first year students during anatomy. No commonly used texts or atlases described/demonstrated specific grouped airway anatomy landmarks to enable airway technology navigation and use. Students enthusiastically embraced the short tutorials and medical technology while rotating chronologically between stations. They subsequently facilitated individual stations (experience one‐teach one).

CONCLUSION

Airway anatomy for intubation, bronchoscoping and ultrasound skills are somewhat of an enigma, as logically it appears simple but in reality is relatively complex and challenging even for experienced providers. This study revealed recognized clinical anatomy airway landmarks are not highlighted or grouped together in common texts/atlases to better enable a learner to orientate themselves while using airway technology to perform tasks. Future studies are assessing students recognition of airway anatomy landmarks and efficient use of current airway technology.

Support or Funding Information

None to disclose.