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0197 Simulating Adam (aintree Difficult Airway Management). A Simple Technique To Increase Mannequin Airway Fidelity
  1. Louise Schofield1,
  2. Chris Goddard2,
  3. Dave Coleman1,
  4. Peter Groom2
  1. 1Centre for Simulaiton and Patient Safety, Liverpool, UK
  2. 2Aintree Hosptial, Liverpool, UK


Background The 4th national audit project (NAP 4) by the Royal College of Anaesthetists, analysed human factors involved during the adverse management of difficult airways (1). Common themes included fixation errors, poor planning and a lack of understanding of team working and communication (1). NAP 4 recommended that human factors training using simulation scenarios should be undertaken in order to rehearse technical and non technical skills (1). The Aintree Difficult Airway Management (ADAM) course is a one day course aimed at teaching techinical advanced airway skills and planning skills for difficult airway management.

Description In collaboration with ADAM faculty, The Centre For Simulation and Patient Safety has developed a high fidelity airway simulation training course. To facilitate the teaching of advanced airway management techniques, the ADAM faculty developed a method of deforming the TRUCORP AIRSIM airway. This involves taping urinary catheters to various structures within the mannequin’s airway. When the catheter balloon is inflated, it causes airway distortion. Examples of malformations that can be simulated include airway tumours, abscesses and strictures. Together, we have incorporated this technique into the airway of Laerdal’s Sim Man 3G, and applied moulage to increase fidelity.

Improvements/outcomes This technique has allowed us to develop 6 high fidelity simulation scenarios designed to teach team resource management and human factors in emergency airway situations. The course will be piloted in June and will be evaluated using pre and post course questionnaires. We hope to show that participants feel more confident in managing difficult airways. We also hope to demonstrate that the airway deformities we create are of sufficient fidelity and they provide good haptic feedback.

Take home messages The airway fidelity of simmulation mannequins can be increased using this simple technique. This can then be used in simulation scenarios to potentially improvve technical and non technical skills.


  1. Cook T, Woodall N, Frerk C. (2011) The fourth national audit project of the Royal College of Anaesthetists and Difficult Airway Society. Major complications of difficult airway management in the United Kingdom.

  • Category: Course or curriculum evaluation/innovation/integration

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