Education on Laryngospasm Management in Pediatric Anesthesia

Abstract

Introduction Laryngospasm, a protective reflex closure of the glottis in response to a stimulus, is a critical event in pediatric anesthesia, responsible for nearly half of post-extubation airway obstructions. The incidence in children ranges from 1-15%, with complications such as oxygen desaturation, bradycardia, pulmonary aspiration, obstructive negative pressure pulmonary edema, and cardiac arrest. Early exposure to laryngospasm management can significantly benefit anesthesia residents, anesthesia fellows, and medical students. This study aims to outline the educational benefit of laryngospasm simulation to improve resident competence in identifying, diagnosing, and managing laryngospasm and its complications. Methods Laryngospasm in the pediatric population is demonstrated through case simulation. Learners are given a case stem and background prior to simulation start. The case background and progression varies to target various learners, including third- and fourth-year medical students, first-year anesthesia residents, and first-year pediatric anesthesia fellows. Key learning objectives are identifying intraoperative changes in ventilation, diagnosing laryngospasm, effectively treating difficult ventilation/laryngospasm, managing complications arising from laryngospasm, and understanding risk factors associated with laryngospasm. After the laryngospasm simulation, a set of debriefing questions are administered to gauge the learner experience. Learners are evaluated based on the ANTS system (Anesthetists Non-Technical Skills), which rates the situational awareness, decision making, team working, and leadership skills. Learners are also scored on their ability to meet the learning objectives appropriately with respect to their position, with pediatric anesthesia fellows having a higher expectation to meet full requirements relative Conclusions Early education and training in laryngospasm management are crucial for anesthesia residents, particularly during their initial pediatric rotations. The structured educational approach, combining didactic learning, simulation, and hands-on practice, effectively enhances resident competence and confidence in managing laryngospasm. This training not only improves patient safety but also prepares students to handle one of the most common and potentially severe complications in pediatric anesthesia. While we have data on the success of early anesthesia education for residents, future studies should focus on gathering data on outcomes for students and other members of the healthcare teams as well as across other institutions to standardize resident education in laryngospasm management.