Difficult airway management is just that… difficult. But a gaming and simulation program is making training for the condition easier.

When life-threatening airway situations occur, medical professionals only have minutes to perform potentially life-saving procedures. This is a fact even more health care professionals and trainees have come to understand during the COVID-19 pandemic.

Dr. Jessica Feinleib

But training to perform these procedures did not always follow a standardized methodology. That’s why Dr. Jessica Feinleib decided to develop the award-winning Difficult Airway Algorithm and Rescue Cricothyrotomy (DAARC) simulation program.

Feinleib is staff anesthesiologist at VA Connecticut Healthcare System and VA’s SimLEARN national course director for Out of OR Airway Management.

Novel training system for difficult airway management

DAARC is a novel composite training system of serious gaming, videos, podcasts and simulation provided as a phone app. It delivers knowledge-based training for difficult airway management.

It also delivers the indications for and techniques of rescue cricothyrotomy which is an incision made through the skin and cricothyroid membrane to establish a patent airway.

Feinleib says her motivation for developing DAARC stemmed from hearing about tragic cases where patients’ airway was managed incorrectly, resulting in loss of life or significant health issues.

She views DAARC as an opportunity to reimagine airway management, creating a standardized methodology for the entire interprofessional health care team. This ensures collective understanding of the procedure with the goal of improving patient safety and outcomes.

Improves decision making with tools and processes

Veteran Aurelio Maldonado collaborated with Feinleib to develop DAARC.

Maldonado works with the VA Employee Education System (EES), which provides the implementation, evaluation and delivery of VA training products in different modalities, including simulation and game-based learning.

According to Maldonado, DAARC helps clinicians improve decision making while using appropriate airway management tools, steps and processes through simulation. It also provides a safe environment to practice airway management procedures, effectively preparing clinicians and trainees to respond when the moment comes to perform the procedure in real time.

VA and private sector clinicians across the U.S. and other countries use DAARC. DAARC is now an integral part of the American Board of Anesthesiologists maintenance of certification process.

Feinleib was recognized for her achievements in simulation learning and education with the 2021 David M. Worthen Innovator Award. The Worthen Awards are VA’s highest honor for outstanding achievements in health professions education.

Learn more

VA conducts the nation’s largest training program for more than 120,000 health professional trainees annually in affiliation with over 1,800 educational institutions across the country, including 97% of the United States’ medical colleges.

VA’s Office of Academic Affiliations coordinates these academic affiliations, some of which began 75 years ago.

Visit the Office of Academic Affiliations. Learn more about VA’s academic mission.

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