From the Research
ENT residents are not necessarily more proficient in managing difficult airways compared to residents in emergency medicine, general surgery, or anesthesia. Each specialty develops different airway management skills based on their training focus.
- Anesthesiology residents typically receive the most comprehensive training in routine airway management, as they perform hundreds of intubations during their residency and learn various techniques including direct laryngoscopy, video laryngoscopy, fiberoptic intubation, and supraglottic airway placement 1.
- Emergency medicine residents develop skills in rapid sequence intubation and managing airways in crisis situations with limited information 2.
- ENT residents excel specifically in surgical airways and managing anatomically complex cases, particularly those requiring specialized procedures like tracheostomy 3.
- General surgery residents typically have less focused airway training compared to these other specialties. The most effective approach to difficult airways often involves collaboration between these specialties, as they bring complementary skills. For instance, an anesthesiologist might attempt conventional intubation methods first, while having an ENT surgeon ready to perform a surgical airway if needed 4. Proficiency ultimately depends on individual training experiences, case volume, and the specific type of airway challenge encountered 5. In real-life clinical practice, the ability to manage difficult airways effectively is crucial for reducing morbidity, mortality, and improving the quality of life for patients, and thus, a collaborative approach is often the best strategy. Key factors influencing proficiency include the frequency of exposure to difficult airway cases, the variety of techniques learned, and the opportunity to practice these skills in a controlled environment 2. Given the complexity and variability of difficult airway scenarios, no single specialty can be deemed universally more proficient than others; rather, each brings unique strengths to the management of these challenging cases.