Airway Management in Trauma: Defining Expertise

Prompt attention to airway management is a fundamental component of the approach to trauma anesthesiology. While anesthesiologists manage the greatest number of airways in their training and practice, a variety of medical providers perform airway management in the trauma population (i.e., paramedics, emergency physicians, anesthesiologists, respiratory therapists). Rates of successful intubation can vary widely between groups; therefore, a definition of expertise is required to develop training plans, as well as standards for maintenance of proficiency. While competency is challenging to define in any field, the data suggest that individuals with the greatest experience achieve the highest level of success. Given that anesthesiologists manage several thousand airway encounters throughout their training and careers, their leadership as subject matter experts is essential to development of training curricula in airway management of all varieties. Consensus on training of less experienced providers, as well as tasking of the most difficult cases to the most experienced provider, is imperative for successful airway management in trauma.