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Prehospital Pediatric Airway Management Training and Education for Community Emergency Medical Technicians

The Children's Hospital in Aurora, Colorado

With the support of a 2009 grant from the R Baby Foundation, The Children’s Hospital (Aurora, Colorado) is developing and implementing a novel paramedic training course designed to increase infant airway skill management, retention, and understanding of capnography using high fidelity simulation techniques. Community paramedics will receive one-on-one pre-simulation equipment training and capnography education, hands-on practice using an infant-sized high-fidelity mannequin, and feedback for skills including bag-valve mask (BVM) ventilation, traditional endotracheal intubation (ETI) technique, capnography interpretation, and novel airway techniques including the laryngeal mask airway (LMA) and the King LT airway.

Pediatric patients constitute 10% of the population cared for by paramedics nationwide. Of this group, 1% requires advanced skills such as airway management. This course, conducted by The Children’s Hospital, provides focused, pediatric-dedicated education to this vital, yet rarely practiced skill.

Use of high-fidelity simulation education in conjunction with four airway techniques and a focus on capnography and interpretation is unprecedented. The use of high fidelity simulation directly affects the competency and retention of airway skills in physicians. No study has addressed this concept in the prehospital provider using all of these modalities. Local Colorado data has demonstrated a need for improvement in pediatric airway management. The Children’s Hospital chart review January 2007 – June 2007 revealed that of nine infant prehospital intubations, three (33%) required re-intubation in emergency department.

FIRST YEAR ACCOMPLISHMENTS:
Earlier this year, the Children’s Hospital developed a training program for EMTs focusing on pediatric airway management. Community paramedics receive one-on-one pre-simulation equipment training and capnography education, hands-on practice using an infant-sized high-fidelity mannequin, and feedback for skills including bag-valve mask ventilation, traditional endotracheal intubation technique, capnography interpretation, and novel airway techniques including the laryngeal mask airway and the King LT airway. Led by Dr. Stephen Daniels, the program should make a significant impact as it spreads R Baby’s mission to properly train and educate any professional who handles a baby.