Bill Klaproth (Host): This is an AAOMS on the Go podcast. I'm Bill Klaproth, and with me is Dr. Bill Chung, Professor and Residency Program Director in the Department of Oral and Maxillofacial Surgery at the Indiana University School of Dentistry. He is here to discuss office-based emergency airway management or OBEAM. Dr. Chung, welcome.

William L. Chung, DDS, MD (Guest): Thank you, Bill. I appreciate the opportunity to invite me here.

Host: Yeah, thank you so much for your time. We appreciate it. So first off, Dr. Chung, what exactly is OBEAM? If you can explain it to us, and why is it important for oral and maxillofacial surgeons?

William L. Chung, DDS, MD (Guest): Sure. So as you had mentioned, OBEAM stands for the Office Based Emergency Airway Management, and it happens to be a component of the AAOMS National Simulation Program.

So it's a course that, in its onset, has been discussed and developed over a decade's time. And it allows the membership to perform hands-on training using the art and technology of simulation. And the use of simulation allows the membership to practice critical airway management techniques, reducing the incidence of emergencies and preparing not only the surgeon but his or her staff to act in unison to improve patient safety in the office.

Host: So, Dr. Chung, when would someone need to utilize these skills? If someone was in a bad accident and their airway was crushed, is that when this comes into play or…? 

William L. Chung, DDS, MD (Guest): Well, certainly, certain aspects of OBEAM are used by other departments in, say, a hospital setting in the emergency medicine department. But for this particular course, it's meant to facilitate the confidence and the development of certain techniques or skills, skills that most of our membership were already taught and may have used during training, but may not have actually had to rely on that for over a decade because they've not encountered an airway emergency. So the situations usually arise when a patient is being sedated in the office for a dental procedure.

Host: Okay. That makes sense. So then what specific techniques and skills do participants learn during the OBEAM course?

William L. Chung, DDS, MD (Guest): So OBEAM will go over very briefly certain sedation monitoring techniques, but then it allows the provider to refresh one's skills and memory in terms of airway opening methods or the triple airway maneuver, the supplemental oxygen techniques that are used, and one- and two-person back mask ventilation techniques.

It also reinforces the use of the laryngeal mask airway or a supraglottic device to assist in ventilation of a patient who may be going through an airway crisis. We have basically determined through past untoward events that thinking that a surgeon may have to use a surgical airway in the office to re-establish an airway is probably not an ideal path that one wants to go down.

And so we're really encouraging the membership to take a step back and utilize something that's hopefully more safe, more predictable, and not necessarily a panacea or a guarantee in every scenario, but one that's going to allow the patient to have a better outcome. And again, that would be using the LMA or laryngeal mask airway.

Host: You mentioned earlier that this is simulation based. So, how does the simulation-based approach enhance learning compared to traditional methods?

William L. Chung, DDS, MD (Guest): What's happening is that in these occurrences, the mannequins are hooked up to either a 3G, 4G, or 5G model, and it allows the participant to practice these skills that we just mentioned.

It allows the participant to have incredibly detailed feedback on his or her performance, such as knowing that you're delivering the appropriate number of breaths in a certain time period or the proper volume when you're trying to resuscitate this mannequin or the patient, so be it.

And the information and data that's tabulated is remarkably beneficial and accurate. So it's quite useful in terms of validating why the course exists and what it's meant to accomplish, which again is to refresh the surgeon's skill set and obviously improve patient safety in the office.

Host: So what you described, it's almost fairly close to real world, the way it's monitoring and the way you described it the number of breaths you're able to, to follow that along to make sure you're doing it correctly it's simulation so it fairly duplicates a real world situation? 

William L. Chung, DDS, MD (Guest): As close as you can imagine, because again, it's simulation, but you have to sometimes step away from the fact that you are working on a mannequin, but sometimes you have to suspend disbelief. 

Host: Sure. Absolutely.

William L. Chung, DDS, MD (Guest): Yes, so that's the key.

Host: So then what are the requirements for AAOMS members who want to participate in the OBEAM program?

William L. Chung, DDS, MD (Guest): So there's an online component to the course, which is highly encouraged to be completed before attending the live session at one of the many meetings that one can sign up for. And it's open to all AAOMS fellows and members, and it's even open to AAOMS resident members.

And essentially, by the time one completes the pre-course online component and the hands-on skill set, one will receive six CE credits for completing this course.

Host: Okay. So then, how does OBEAM fit into the broader requirements for anesthesia management compliance by 2026?

William L. Chung, DDS, MD (Guest): This is compulsory. And I believe the set date is the end of calendar year 2026. And it's going to be required to maintain membership in AAOMS.

Host: Hmm. Okay. So if you're an AAOMS member, you have to go through the OBEAM training? Is that, did I hear you right or am I, did I not hear you right?

William L. Chung, DDS, MD (Guest): I'm certain that that's the expectation.

Host: Okay. Interesting. Well, this has been really fascinating. It sounds like from your perspective, this is something every OMS should want to partake in, and obviously it sounds like it's going to be a requirement, but even before the end of 2026, which is a couple of years away, it sounds like this is something beneficial for every OMS.

William L. Chung, DDS, MD (Guest): Absolutely. Because again, some of these skills, we may not have had the opportunity to practice in real time or on a real patient in possibly decades. And you just don't want to be caught unprepared during a real-life crisis. So the beauty of this course, again, is to basically, reestablish your comfort level, and maybe even learn a couple of fine points and refine your previous technique.

And what I found to be really essential and beneficial of this course is it also allows you to recapture some information so that you can translate it onto your office staff, making them feel more empowered. So they feel definitely more of a essential component of the team concept in managing these emergencies that occur in the office.

Host: Yeah, so other benefits as well, it sounds like.

William L. Chung, DDS, MD (Guest): Absolutely.

Host: Yeah. Well, Dr. Chung, this has been great. Thank you so much for your time today. Before we wrap up, is there anything else you want to add?

William L. Chung, DDS, MD (Guest): I've basically felt that the technology and art of simulation has been truly one of the most cutting-edge advantages of new learner opportunities. And I think it's one of the most unique opportunities for delivering a certain skillset or information. So I find that it's been probably the most useful type of CE that I've taken in well over a decade. A lot of very dedicated, capable people have worked very hard to put details of this course together over the past decade. It's probably now in its, maybe third iteration.

So it's something that's been constantly reviewed and trying to be modified so that people who partake in it can really walk away saying, boy, it was not only worth my while because it just refreshed my memory and my skill set, but I actually learned possibly a new technique that I feel that confident is going to improve patient safety, which is what this really boils down to.

Host: Yeah, very well said, and really important information. Dr. Chung, thank you again for stopping by. We appreciate it.

William L. Chung, DDS, MD (Guest): My privilege, and thank you so much.

Host: Yeah, once again, that is Dr. Bill Chung, and for more information, visit AAOMS.org/OBEAM, that's O-B-E-A-M, AAOMS.org/OBEAM for more information. And if you enjoyed this podcast, please share it on your social media, and make sure you subscribe so you don't miss an episode.

Thanks for listening.