Limitation This study had some limitations that should be considered when interpreting the results. Our sample size was small and suboptimal. Further prospective studies need to be completed in larger scales to validate

the role of such rotations. Another limitation was the fact that certain complications were not assessed. There was certainly the potential for selection bias that could have been responsible for the differences noted in these rates. Also, the study was completed on patients with relatively Inhibitors,research,lifescience,medical easy airways, raising the possibility that the results could not be generalized. Other limitations • The experiment had to be confined to a single site. • The number of participants was small and limited. • The duration of Skills Lab program is only Inhibitors,research,lifescience,medical 36 hours whereas our studied anesthesiology rotation is one month long. Better results are more likely to be obtained from studies carried out in longer periods. • The study lacked control group. • We did not have adequate number of attempts to achieve reasonably consistent skills in bag-mask ventilation or orotracheal promotion intubation. Conclusions Since EMRs’ success

rate in choose size airway management improved after rotating on an anesthesiology rotation, anesthesiology rotations Inhibitors,research,lifescience,medical could be considered as one of the crucial components of EM training programs. We believe that a standardized theoretical instruction program in combination with Inhibitors,research,lifescience,medical a practical anesthesiology rotation improve the skills of airway management in EMRs. Airway management training is a continuous process that should begin with theoretical instruction, continue in the skills lab and operating theatre and end in the ED. All of the above mentioned steps should be supervised by an attending anesthesiologist and/or EP Abbreviations

A and E: Accident and Emergency; ED: Emergency Department; EP: Emergency Physician; EM: Emergency Medicine; EMR: Emergency Medicine Residents; RSI: Rapid Sequence Intubations; UK: United Kingdom Competing interests The authors Inhibitors,research,lifescience,medical declare that they have no competing interests. Authors’ contributions HS and CG collected clinical data, reviewed the literature on the topic, and drafted the manuscript. JRP, RRG and MRA conceived of the study, and participated in its design and coordination. SEJG, MS and RME participated in the design of the study and performed the statistical analysis. All of the authors were involved in patient management or the writing of Carfilzomib the manuscript. All authors read and approved the final manuscript. Pre-publication history The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-227X/11/8/prepub Acknowledgements We thank Dr.Terry Kowalenko, MD, Clinical Associate Professor, Department of Emergency Medicine, University of Michigan. We would like to express our deep gratitude to him for his comments on our paper.