Ateliers « intubation difficile » : impact sur les connaissances et les pratiques

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Objectives To evaluate the impact of difficult intubation workshops on airway management knowledge and daily medical practice in anaesthesiology. Study design Prospective survey. Methods The participants to the workshops accredited by the French college of anaesthesiologists (Cfar) in 2003 were invited to answer to MCQ before, immediately and three months after the course. They also completed a questionnaire provided during the workshop and three months later, focusing on medical practice and their own organization in the area of difficult intubation before and after the workshop. Results One hundred (and) seven participants responded to the immediate evaluation (MCQ and questionnaire) whereas 32 responded to the delayed evaluation performed three months later. A subjective scale was used to assess the level of knowledge in difficult intubation (0: lowest level, 10 highest level).The mean score for subjective knowledge considering difficult intubation was 4.7 ± 2.3 before the course and 6.9 ± 1.6 at 3 months ( P < 0.001). The mean scores attributed to MCQ were not different before and after the workshops. Participants expected complementary practical training (65%) and theoretical courses (40%). Delayed evaluation revealed that 25/32 participants had to deal with difficult intubation during their clinical practice after the workshop, but 3 cases (12%) could not be managed with success. Defects could be observed in terms of organization: no difficult airway trolley (22%), no predefined difficult airway algorithm (66%), and information: no written information given to the difficult airway patient (44%), and no information given to the difficult airway patient's home doctor (91%). Discussion These results showed that difficult intubation remains a real problem for anaesthesiologists. They also revealed differences between subjective and objective knowledge and pointed out defects in terms of organization and management which should be improved.