The Neonatal Difficult Airway Course – A Collaboration between Three Teaching Hospitals in the UK

Background: Encountering a difficult airway in a neonate is a life-threatening emergency. Contrary to practice in older children there are no national guidelines available in the UK to facilitate a structured approach. The course was initiated at the Princess Anne Hospital Southampton and rolled out through collaboration with the University Hospital of Wales Cardiff and Abertawe Bro Morgannwg University Healthboard.

Objectives: The course focuses on assessment and decision making for neonatologists faced with a difficult airway.

Methods: The course is designed in a multidisciplinary fashion to give neonatal, surgical and anaesthetic perspectives involving lectures from ear, nose and throat surgeons (ENT), Anaesthetists and Neonatologists to provide background information about anatomy, common problems and practical approaches. There is a series of workshops to allow participants to practise skills with video-assisted technology (GlideScope®, Storz C-MAC®, InfantView from ACUTRONIC), laryngeal masks and i-gel®. ENT surgeons demonstrate surgical equipment and discuss surgical airways. Neonatologists demonstrate the use of a difficult airway trolley and guidelines in clinical practice. The second part of the day consists of simulation training with small groups rotating through 4 scenarios to put learning into practice.

Results: The course has run 5 times in involved centres in the UK, with plans to run more courses in other locations. Feedback is consistently high with over 93% of participants rating the course as good or excellent and over 93% of participants agreeing that the course was effective and would change their clinical management. A thematic analysis of comments concluded the participants would ‘highly recommend’ and it was ‘helpful’ with ‘realistic’ methodology.

Conclusions: We believe The Neonatal Difficult Airway Course has demonstrated its usefulness with persistently very good feedback and hope that it will give attendees a frame work to deal with this difficult clinical scenario in a structured and logical way.