Teaching old dogs new tricks

I have just got back from the Airway Skills course held in Sydney and run by Paul Baker (airwayskills.com). Unlike other courses, this was was genuine small group learning with plenty of opportunity to discuss cases, get hands on with a variety of equipment and was suitable not just for anaesthetists, but also intensivists, ED docs and rural proceduralists.

Its amazing how much one can learn even when one is doing a job on a daily basis. Paul Baker is well known as the author of numerous papers and the ANZCA ‘difficult airway’ equipment recommendations. As such, he brings a calm authority to discussion of airway and was a patient teacher.

I got a chance to play with a variety of equipment, including understanding the vital difference between proseal and supreme LMAs, play with combitubes, fiddle with Frova’s, Aintree catheters and confirm my choice of scalpel-bougie-tube for surgical airways. Also a great session on AFOI, as well as discussion of using 15l/min O2 via nasal specs as an adjunct to preoxygention/RSI and Levitan’s excellent airway book…

Only one thing was missing – a ‘soiled airway’ mannikin, to simulate the emergency airway that is the province of trauma and emergency docs…I know Minh le Cong has been muttering about such a simulator, but I reckon it’d be a great chance to wet test some ideas like Weingart’s ETT as suction catheter.

Rural docs have a plethora of courses to choose from – EMST, APLS, ELS, RESP, MOET, ALSO etc, as well as clinical attachments for procedural upskilling. I’ve blogged previously about the excellent Rural Doctors NSW procedural conference (combined with a day at the sim lab for GP-anaesthetists) and how I’d love to bring a conference with similar content to South Australia. The Baker airway skills course is so good that I reckon it’ll soon become oversubscribed, and the rural proceduralist cohort may miss out…wouldn’t it be great to bring this paradigm to a wider audience, rather than just 3-4 courses per annum on Oz and NZ?

4 responses to “Teaching old dogs new tricks

  1. Tim, I undertook that course last year it was fantastic. I think what is missing in the "course landscape" is the rural generalist course, with trauma, airway, med/ paed emergencies and obstetrics in one course. As rural generalist's we need a course like this vs doing the EMST/ELS/APLS/ALSO and airway course. What do you think??

  2. Yes, you could be right. One of the problems I have with these courses is that they aren't always geared for the reality of rural medicine – EMAC was a case in point…when faced with a potentially difficult airway, most of the anaesthetic candidates and instructors favoured AFOI….or use of a C-MAC or some other piece of kit which we dont have. Medicine for rural generalists is often resource limited.I reckon the RESP/REST course comes close, but dont think it has any obs component. Of course, to cover EM-anaes-O&G-paeds-trauma in any detail would probably require a five day residential course….Hang on, maybe akangaroo Island could be the place to host this? And tie in with a holiday.Ray, you up for collaborating on a mega-rural docs moulage

  3. Tim,Sounds like a great plan. I am keen. With ACRRM we have all the docs and the resources to assist with this. I was going to chat with Peter Arvier about this as well.

  4. Yeah, I've met Peter through ASEM and a few ELS courses…he's a good champion for rural EM.I do think the RESP/REST courses have the guts of this, but (like you) have been toying with developing something that takes people out of classroom and covers several areas relevant to rural practice…also keen to keep up-to-date and debunk a few myths (I teach on EMST, and whilst it's fun, I do sometimes get tired of some of the dogma…want to be talking finger thoracostomy, permissive hypotension, major transfusion protocols etc etc).Flick me an email Ray and we should talk further. drimATwrongsideoftheroad.com.au

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