Airway management in emergencies is always complex and the most important factor in achieving success is deliberate practice. Deliberate practice requires ‘effortful’ challenging repetition with expert feedback that can make complex, cognitive and psychomotor processes simpler for easier retrieval and execution. Unfortunately in medicine, we rarely practice after completion of our mandatory academic training. Compare this to athletes, musicians and other high stakes professionals such as military Special Ops teams. While mental rehearsal is commonly used by high performance athletes to help the individual visualize and imprint their immediate task, checklists are tools that are meant to help both individuals and teams execute a common task.
Learners routinely communicate their equipment needs during airway simulations and there are no shortages of mnemonics produced to ‘help’ clinicians remember what stuff to have ready. Do you need a mnemonic to remember an ETT, BVM and laryngoscope? If you do, you’re in trouble! What we do need is help with is remembering the little stuff that can reduce errors and improve our goal of first pass success without complications, particularly in times of stress. Designing a checklist is a battle between wanting to be comprehensive and keeping true to simplicity. This is the latest version of our checklist and while it appears busy it serves 2 purposes. First it serves as a comprehensive reminder for the lead airway manager of the key components required successful intubation. Second (yellow highlighted components) it serves as a prompt for the airway manager as to what should be communicated to the team to promote a shared mental model.