Avoiding & Managing the Challenging Airway-A Team Approach (2022 AMW) Evaluation
2022 AAO-HNSF Annual Meeting & OTO Experience
The incidence of pediatric airway pathology in low-resourced settings vastly outpaces the ability of tertiary care providers to provide treatment for this pathology. As part of a longitudinal, multi-disciplinary effort to provide airway care in LMICs since 2010, the panelists will discuss lessons learned based on collective experiences in Ecuador, El Salvador and the Dominican Republic where we have established centers of pediatric airway excellence in Latin America. We discuss an incremental 5-year learning paradigm that begins with the local surgeon observing complex surgeries during year 1 to eventually graduating to becoming the primary surgical provider. The multi-disciplinary nature of this learning model is imperative and therefore surgeons teach surgeons, ICU providers teach ICU providers, anesthesiologists teach anesthesiologists, SLPs teach SLPs, nurses teach nurses and eventually parents teach parents. This symposium will discuss our model from the perspective of both the local surgeon and the primary teaching surgeon with specific modifications highlighting how we altered or model when travel was limited during the COVID pandemic. We will also review several modifications we have made to standard airway surgical technique including the 1.5 stage LTR, construction of essential airway management equipment (needle cricothyroidotomy kit, endotracheal tube within a tube for adult-sized patients with severe subglottic stenosis, etc) using basic universal supplies. We will discuss a locally initiated educational module that utilizes QR codes to facilitate surgical and support staff teaching. We hope this symposium facilitates safe airway collaboration for both international surgeons in low-resourced settings and surgeons who travel to LMICs to lead mission work.