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MCCTP Workshop Series

Routine Airway
Director: Lillian Liang Emlet, MD
Faculty: Jason Moore, MD, Steve Orebaugh

DescriptionFellows learn routine airway management with focus on BVM ventilation, direct laryngoscopy, and laryngeal mask airway using didactic instruction and practice with simulation.  Basic technique and considerations for ventilatory support of critically ill patients is emphasized.

Cadaver Airway Lab
Director: Steve Orebaugh
Faculty: Hernando Gomez Danies, MD, James Snyder

Description: Fellows learn direct laryngoscopy and BVM skills utilizing specially prepared human cadavers that allow practice on airways of variable difficulty with attention to technique and fine motor skills of laryngoscopy.

Learning objectives:

  1. Demonstrate patient positioning and equipment setup that maximizes ability to successfully ventilate and intubate.
  2. Demonstrate an efficient and effective means of communication with team members assisting with airway management.
  3. Demonstrate effective bag valve mask ventilation that optimizes ability to oxygenate patients prior to intubation and to rescue patients after failed direct laryngoscopy.
  4. Demonstrate effective direct laryngoscopy including use of bimanual laryngoscopy and fine motor control of the epiglottis.
Difficult Airway
Director: Lillian Liang Emlet, MD

Description: Fellows learn difficult airway management with focus on the ASA Difficult Airway Management algorithm, and practice with the different supraglottic and subglottic techniques used to secure difficult airways. Workshop incorporates hands on practice of all airway devices used and review of didactic material from the noon lecture series.  Individual simulation testing evaluates each fellow's ability to use the DAM algorithm and the various devices.

Tracheostomy Management
Faculty: David Eibling

Description: Fellows learn emergent tracheostomy management and obtain hands-on experience with various types of tracheostomy tubes. Workshop incorporates a small group discussion format and human simulation training with subsequent group debriefing.

Learning objectives:

  1. Demonstrate emergency tracheostomy management in a patient with and without a patent upper airway
  2. Compare and contrast the management strategies of fresh vs old tracheostomies
  3. List the different types of tracheostomy tubes and describe the indications and possible complications of each
Percutaneous Tracheostomy
Director: David W. Crippen
Faculty: Carl Snyderman (ENT), Kees Polderman, MD, Ivonne Daly

Description: Fellows learn the cognitive and technical aspects of percutaneous tracheostomy.  Workshop incorporates didactic instruction with a cadaver lab affording the opportunity to practice operative technique.  Availability limited for cadaver lab experience with priority given to fellows in their final year of training.

Learning objectives:

  1. Describe the surgical anatomy relevant to percutaneous tracheostomy
  2. Explain the risks, benefits, indications and contraindications for percutaneous tracheostomy
  3. Describe the common intraoperative and post-operative complications of this procedure and explain the management of each.
  4. Demonstrate the proper pre-operative preparation and surgical technique needed to minimize complications.
Ventilator Management
Director: Jason Moore, MD

Description: Fellows learn the practical aspects of ventilator management using mechanical ventilators attached to lung simulators.  Workshop allows fellows to actually change the settings on the ventilators in order to practice managing patients with increased or decreased lung compliance and increased airway resistance.

Fiberoptic Bronchoscopy
Director: Chenell Donadee
Faculty: Edwin Rao

Description: Fellows review airway anatomy, learn proper cognitive and technical aspects of bronchoscopy, and learn about the care of the bronchoscope itself.  Workshop incorporates didactic instruction with human simulation practice using an anatomically accurate partial task trainer.

Learning objectives:

  1. List the most common indications for and describe the possible complications of fiberoptic bronchoscopy (FOB) in the ICU setting.
  2. Describe the proper handling of the bronchoscope before, during, and after FOB
  3. Describe the proper monitoring of patients during FOB and explain the rationale for this monitoring.
  4. Identify all airway anatomy from the vocal cords to the segmental bronchi.
Central Venous Catheterization
Director: Jason Moore, MD
Faculty: Selected 2nd year fellows

Description: Fellows learn proper technique for landmark-guided and ultrasound-guided placement of central lines and the cognitive and technical pitfalls associated with this skill.  Workshop incorporates didactic instruction, an online training component, and human simulation practice using partial task trainers and bedside ultrasound.

Learning objectives:

  1. Demonstrate proper approach with introducer needle during placement of central lines from all three (Internal Jugular, Subclavian, and Femoral) sites.
  2. Demonstrate proper technique for manual manometry and stabilizing introducer needle prior to guidewire insertion.
  3. Demonstrate proper technique for viewing needle and anatomic structures using bedside ultrasound.
Chest Tubes, Knot Tying, and Suturing
Faculty: SCC fellows

Description: Fellows learn proper knot tying and suturing techniques as well as the cognitive and technical aspects of chest tube placement.  Workshop incorporates didactic instruction with hands-on practice of two-hand knot-tying using knot-tying boards, and practice of chest tube placement through a simulated chest wall.

Learning objectives:

  1. List the indications for and potential complications of chest tube placement.
  2. Demonstrate proper technique for chest tube placement.
  3. Demonstrate proper technique for two-handed knot tying.
  4. Describe the appropriate management of chest tubes, including appropriate timing and technique of removal as well as management of common complications.
Crisis Team Training
Director: Lillian Liang Emlet, MD
Faculty: Nicolette Mininni, Wendy Grbach

Description: Fellows learn and practice crisis team communication skills while working with healthcare providers from different training backgrounds, including nurses, respiratory therapists, and physicians of all training levels.  This interdisciplinary simulation training incorporates team practice in crisis situations with detailed debriefing of group performance in a small group interactive format.

Obstetrical Crisis Team Training
Director: Marie Baldisseri, MD

Description: Optional workshop for fellows who wish to practice team communication skills during an obstetric crisis.  Workshop incorporates didactic instruction regarding common obstetric emergencies and practice with communication skills between the various services present (OBGYN, anesthesia, CCM, nursing, respiratory, etc) using human simulation scenarios.  Availability limited to one CCM fellow per session – first come, first serve.

Critical Care Ultrasound
Director: Christopher Schott, MD, MS, David John Wallace, MD

Description: Fellows go through online didactic curriculum (CAE ICCU curriculum) first, and then have small group workshops on Lung Ultrasound and Cardiac Ultrasound.  Technique and understanding of required image interpretation is reviewed and practiced.

Critical Care Communication (C3) Course
Director: Jane Schell (Palliative Care)
Faculty: Robert Arnold, Rene Claxton, Lillian Liang Emlet, MD, Jason Moore, MD

Description: Fellows develop and practice skills for communicating with families in the setting of end-of-life care in the ICU.  Specific skills include delivering bad news, discussing goals of care, and dealing with conflict.  All of these skills are presented in the context of addressing the emotions of family members.  This collaborative workshop between CCM and Palliative care is one of the highlights of our fellowship training program!