Objective This study on a medium-fidelity simulator (SimMan

Laerdal Medical Corporation

Wappingers Falls

NY

USA) examined the management of unanticipated difficult airway by residents of anesthesiology and the effect of training in this context. Methods 30 residents of anesthesiology were devided into two groups (T and E). There were two scenarios investigated: ‘can’t intubate

can oxygenate’(CI) and ‘can’t intubate

can’t oxygenate’(CICO). Volunteers underwent initial evaluation before or after training in the ‘Difficult Airway Society’ (DAS) algorithms and associated technical skills. At 2 months and 6 months

performance was compared between the two groups according to the ‘ideal’ management plan. Data were analysed using t test

M-W test and χ2 test. Result In CI

success rate of placement of astandard and intubating laryngeal mask airway were high in T group (87% vs 55%

P =0.037). This was sustained over time. There was no different in duration and incidence of desaturation between two groups. In CICO

there was a more structured approach following training in T group (p < 0.05)

which wasn’t sustained over time. But this was sustained over 6 months in E group. Conclusion Simulation-based training significantly improves performance of management of unanticipated difficult airway. Training should be repeated at intervals of 2 months or less.