Main Theme: Airway
Introduction
Paediatric airway emergencies are high-stakes, infrequent events that generate significant anxiety among ENT surgeons across all grades. [1] Limited exposure during training compounds this, particularly in District General Hospitals (DGHs). A regional face-to-face refresher course was developed and delivered to ENT and anaesthetic colleagues at Walsall Manor Hospital to address technical proficiency and confidence in paediatric airway management.
Methods
Three plenaries covered paediatric airway scenarios, managing difficult cases in a DGH, and rigid bronchoscopy and paediatric tracheostomy principles. A practical session involved bronchoscope assembly and simulated foreign body removal. Pre- and post-session surveys used 5-point Likert scales to assess confidence. A separate survey evaluated ENT scrub nurses' familiarity with bronchoscope assembly. Concurrently, the paediatric bronchoscope tray was audited to assess equipment readiness for clinical use.
Results
Audit of the paediatric bronchoscope tray identified missing components, rendering it unfit for emergency use; a new bronchoscope was subsequently procured. Among 17 clinicians, confidence in performing rigid bronchoscopy increased by 58.9% (23.5% pre- to 82.4% post-session). All attendees reported improved understanding of paediatric airway scenarios and bronchoscopy principles; 94.1% reported improved confidence managing difficult DGH cases. None of the scrub nurses (n=6) had previously assembled a bronchoscope; 83.3% reported low confidence, and all felt a course would benefit their practice.
Conclusion
This quality improvement initiative identified critical gaps in both equipment readiness and clinical skills. Bronchoscope tray audit prompted essential procurement; simulation training yielded significant gains in proficiency and confidence. Future follow-up will assess long-term impact on clinical practice.
References
[1] ENT and Audiology News. Challenges in paediatric airway management [Internet]. [Cited 19/06/2026]. Available from https://www.entandaudiologynews.com/features/ent-features/post/challenges-in-paediatric-airway-management