By Allan Brown, M.D.
The bandwagon of difficult airway diagnosis and skills training is rolling on. So far this year more than 50 postgraduate meetings devoted to the subject, or as tack-on workshops for other meetings devoted to more general topics, have been advertised. This is a far cry from the situation in 1986 when Dr. Martin Norton and I set up the department's Difficult Airway Clinic.
Our conviction of the need for a more systematic approach to the diagnosis and management of the airway and its problems was greeted with tolerant amusement in the department and a deafening silence elsewhere. A distinguished editor of one of the major national anesthesiology journals assured us that there was no interest in publishing anything about the airway, as the topic was a simple one and the necessary skills were acquired early by every resident.
Since we had already started to organize our first three day difficult airway course for 1987 in Ann Arbor before we received these comments through the mail, we proceeded anyway. Contrary to all expectations, this first course was more than 100% oversubscribed by anesthesiologists in private practice. Based on the comments received from those first registrants, there was obviously a demand for focused courses of this sort. The Towsley Center for Postgraduate Medical Education was also sufficiently convinced that it lent its support in starting similar annual courses in Florida and Arizona All three courses have since been fully subscribed.
The Florida course is held each January in Lake Buena Vista at the Disney Yacht Club Resort. The Arizona course is held in March in Scottsdale at the Red Lion La Posada resort. The Ann Arbor course is held in the fall, usually one or two weeks following the ASA annual meeting. As we approach the 10th anniversary of this teaching effort, the annual course in Ann Arbor has changed from an open training course to a closed one tailored to the needs of our own first year residents and any other members of the department who wish to attend. In 1994, the emergency room residents were admitted to the course and this year the general surgery residents have expressed an interest in joining.
The other two courses remain dedicated to the needs of anesthesiologists in private practice, and both are still oversubscribed. The promulgation of the ASA Difficult Airway Algorithm following the report of the closed claims study in 1989 did much to stimulate continuing interest in the subject together with the recent plethora of new courses on the airway at other institutions.
Much to our surprise, this new competition seems to have done little to dampen interest in the offerings from Michigan. All three of the original teaching faculty, Marty Norton, Barry Powell and myself are still actively involved with each course, although Marty is now retired with emeritus status. The Difficult Airway Clinic continues its activities with a steady stream of patient referrals from our own surgeons and outside hospitals but the original faculty triumvirate is now well seasoned with an enthusiastic group of younger faculty to help with the service.