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. 2025 Nov 13;14(22):8059.
doi: 10.3390/jcm14228059.

Airway Proficiency and Efficiency Amongst Anesthesia Providers and Respiratory Therapists: A Comparison Study

Calleigh G Brignull  1 , Emily B Williams  1 , Harper A Sprouse  1 , Kyle J Adams  1 , Stephanie L Tanner  1 , John W Sykes  1 , Henry Moulder  2 , William R Hand  1 , Robert R Morgan Jr  1
Affiliations

Airway Proficiency and Efficiency Amongst Anesthesia Providers and Respiratory Therapists: A Comparison Study

Calleigh G Brignull et al. J Clin Med. .

Abstract

Background/Objectives: Studies have demonstrated significant morbidity and mortality associated with airway management, especially when provided outside of the operative setting. The goal of this study was to compare baseline measurements of airway management procedures between anesthesia providers (CRNAs and anesthesiologists) and respiratory therapists using high-fidelity manikins. Methods: This prospective study assessed anesthesia providers and respiratory therapists performing direct laryngoscopy (DL), video laryngoscopy (VL), and LMA placement. The same Laerdal SimMan high-fidelity manikin (Laerdal, Stavanger, Norway) was used in all assessments, with the detection of end-tidal "carbon dioxide" serving as evidence of success for each procedure. Each procedure was performed twice, once under "Healthy Patient" SimMan settings, and once under the "Limited Cervical Range of Motion (ROM)" (DL), "Pharyngeal Obstruction" (VL), and "Full Tongue Edema" (LMA) settings, respectively, to simulate a moderately difficult airway. The order in which the techniques were performed was randomized for each participant. Completion time and number of attempts were recorded for each procedure and compared between the groups. Results: Sixty-two providers (30 anesthesia providers and 32 respiratory therapists) were enrolled. There were no significant differences in average time to completion for any procedure, except respiratory therapists took longer than anesthesia providers in VL with simulated pharyngeal obstruction (p = 0.0004). There were no differences in number of attempts needed for successful completion. Conclusions: This study demonstrates that while completion times for DL and LMA placement were similar amongst provider groups, average time to completion of VL for respiratory therapists was longer under difficult simulated settings. These results reflect potential areas of improvement for other provider groups that may have airway privileges at their respective institutions.

Keywords: airway management; clinical skills; direct laryngoscopy; laryngeal mask airway; video laryngoscopy.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
View from the manikin head depicting room setup and available equipment.
Figure 2
Figure 2
Overview of manikin, room layout, and available equipment.
Figure 3
Figure 3
Layout of the equipment available to each participant performing the simulation, table one of two.
Figure 4
Figure 4
Layout of the equipment available to each participant performing the simulation, table two of two.
See this image and copyright information in PMC

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