[Skill retention using extraglottic airways in out-of-hospital emergencies: efficacy and long-term results of simulator-based medical education : A prospective follow-up study]

Abstract

Objective: For emergency medicine personnel (EMP), there is little evidence concerning the adequate timing for refresher courses to maintain routine in the application of extraglottic airways. The aim of this study was to evaluate the efficacy and long-term results of a simulator-based education concept teaching the basic airway management skills with extraglottic airways for EMP and also to draw conclusions concerning the adequate time interval for refresher courses.

Methods: By use of an explorative, prospective simulator-study with nonphysician EMP, airway management skills using the Larynxmaske Supreme® (LMA‑S) after an introduction lecture were examined. The application of an endotracheal tube (ETT) served as control. Time for preparation of the airway devices, insertion success, and resulting apnea time were assessed immediately after the first introduction lecture (t1) and unannounced 9-12 months thereafter (t2).

Results: Comparison of the times for preparation of the LMA‑S at t1 and t2 demonstrated similar results. After the introduction lecture, all paramedics were able to insert the LMA‑S successfully after maximal 2 attempts; 9-12 months later success rates with the LMA‑S were unchanged. Apnea time during airway management was shorter with the LMA‑S compared to the ETT (p < 0.01). Times needed for preparation of the airway devices were similar.

Conclusion: The results of this simulator study indicate that a standardized introduction lecture is appropriate to ensure long-lasting procedural skills up to 12 months, so that subsequent refresher courses in basic airway management with the LMA‑S once a year may be adequate. A simulator-based education in basic airway management skills with extraglottic airways is recommended for facilitation of further clinical education according to the current guidelines.

Keywords: Emergency medical technicians; Laryngeal mask; Medical education; Patient safety; Simulation training.