{"pk":52124,"title":"Modification of an Airway Training Mannequin to  Teach Engagement of the Hyoepiglottic Ligament","subtitle":null,"abstract":"Audience: This airway trainer modification is designed to instruct all levels of training in emergency medicine  in order to familiarize trainees with airway anatomy and obtain superior views of the glottic inlet.\nIntroduction: During intubation with a standard geometry laryngoscope, such as the Macintosh blade,  placement of the distal end of the blade within the vallecula and engagement of the median glossoepiglottic  fold, also referred to as the midline vallecular fold (MVF), has long been championed by experts in airway  management for its ability to improve glottic inlet visualization. This notion was further supported by the  recent publication of a retrospective video review by Driver et al.1 Unfortunately, airway anatomy, including  engagement of the MVF, does not receive the emphasis it deserves during intubation training of emergency  medicine residents. Emergency physicians often have limited time to perform complete airway examinations,  but a sound recognition and appreciation of the laryngeal inlet can serve as a roadmap to optimal  laryngoscopy.2\nRecent advancements in airway education emphasize visualization of airway anatomy with review of video  laryngoscopy (VL) recordings to identify routine VL errors in vallecula manipulation, such as failure to engage  the MVF. 3 Simulation can continue to play an essential role in enhancing trainees’ airway skills. Current  airway trainers lack functional fidelity components, such an engageable MVF, resulting in a missed  opportunity to teach airway skills and anatomy in a safe and controlled setting.4, 5 To address these concerns,  we modified an existing airway task trainer with the addition of a simulated MVF to expose trainees to airway  anatomy and adequate MVF engagement resulting in epiglottic elevation.\nEducational Objectives: By the end of this education session, participants should be able to:  1. Identify relevant airway anatomy during intubation, including base of the tongue, epiglottis, midline  vallecular fold, anterior arytenoids.  2. Appreciate the value of a stepwise anatomically guided approach to intubation.  3. Become familiar with the midline vallecular fold and underlying anatomy, including the  hyoepiglottic ligament, and how proper placement of the laryngoscope can result in improved  glottic visualization.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Innovations","is_remote":true,"remote_url":"https://escholarship.org/uc/item/91g2r577","frozenauthors":[{"first_name":"Richard","middle_name":"","last_name":"Tumminello","name_suffix":"","institution":"Einstein Medical Center Philadelphia, Department of Emergency Medicine, Philadelphia, PA","department":""},{"first_name":"Daniel","middle_name":"","last_name":"Patino-Calle","name_suffix":"","institution":"Einstein Medical Center Philadelphia, Department of Emergency Medicine, Philadelphia, PA","department":""}],"date_submitted":"2024-05-01T17:20:55Z","date_accepted":"2024-05-01T17:20:55Z","date_published":"2024-04-30T07:00:00Z","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52124/galley/39403/download/"}]}