Decontamination of Airway Equipment

Fibreoptic intubation, high frequency jet ventilation, and videolaryngoscopy form part of the Royal College of Anaesthetists compulsory higher airway training module. Curriculum delivery requires equipment availability and competent trainers. We sought to establish (1) availability of advanced airway equipment in UK hospitals (Survey I) and (2) if those interested in airway management (Difficult Airway Society (DAS) members) had access to videolaryngoscopes, their basic skill levels and teaching competence with these devices and if they believed that videolaryngoscopy was replacing conventional or fibreoptic laryngoscopy (Survey II). Data was obtained from 212 hospitals (73.1%) and 554 DAS members (27.6%). Most hospitals (202, 99%) owned a fiberscope, 119 (57.5%) had a videolaryngoscope, yet only 62 (29.5%) had high frequency jet ventilators. DAS members had variable access to videolaryngoscopes with Airtraq 319 (59.6%) and Glidescope 176 (32.9%) being the most common. More DAS members were happy to teach or use videolaryngoscopes in a difficult airway than those who had used them more than ten times. The majority rated Macintosh laryngoscopy as the most important airway skill. Members rated fibreoptic intubation and videolaryngoscopy skills equally. Our surveys demonstrate widespread availability of fibreoptic scopes, limited availability of videolaryngoscopes, and limited numbers of experienced videolaryngoscope tutors.

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Awareness of difficult airway equipment on the ICU

Critical Care ◽

10.1186/cc11132 ◽

2012 ◽

Vol 16 (S1) ◽

Author(s):

A Wozniak ◽

A Iyer

Keyword(s):

Difficult Airway ◽

Airway Equipment

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Simulated airway drills as a tool to measure and guide improvements in endotracheal intubation preparation in the paediatric emergency department

BMJ Simulation and Technology Enhanced Learning ◽

10.1136/bmjstel-2020-000810 ◽

2021 ◽

pp. bmjstel-2020-000810

Author(s):

Kei U Wong ◽

Isabel Gross ◽

Beth L Emerson ◽

Michael P Goldman

Keyword(s):

Emergency Department ◽

Endotracheal Intubation ◽

Preparation Process ◽

High Stakes ◽

Paediatric Emergency Department ◽

Staff Members ◽

Paediatric Emergency ◽

Simulation Based ◽

Airway Equipment

IntroductionEmergent paediatric intubation is an infrequent but high-stakes procedure in the paediatric emergency department (PED). Successful intubations depend on efficient and accurate preparation. The aim of this study was to use airway drills (brief in-situ simulations) to identify gaps in our paediatric endotracheal intubation preparation process, to improve on our process and to demonstrate sustainability of these improvements over time in a new staff cohort.MethodThis was a single-centre, simulation-based improvement study. Baseline simulated airway drills were used to identify barriers in our airway preparation process. Drills were scored for time and accuracy on an iteratively developed 16-item rubric. Interventions were identified and their impact was measured using simulated airway drills. Statistical analysis was performed using unpaired t-tests between the three data collection periods.ResultsTwenty-five simulated airway drills identified gaps in our airway preparation process and served as our baseline performance. The main problem identified was that staff members had difficulty locating essential airway equipment. Therefore, we optimised and implemented a weight-based airway cart. We demonstrated significant improvement and sustainability in the accuracy of obtaining essential airway equipment from baseline to postintervention (62% vs 74%; p=0.014), and postintervention to sustainability periods (74% vs 77%; p=0.573). Similarly, we decreased and sustained the time (in seconds) required to prepare for a paediatric intubation from baseline to postintervention (173 vs 109; p=0.001) and postintervention to sustainability (109 vs 103; p=0.576).ConclusionsSimulated airway drills can be used as a tool to identify process gaps, measure and improve paediatric intubation readiness.

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Airway Equipment

Encyclopedia of Trauma Care ◽

10.1007/978-3-642-29613-0_6 ◽

2015 ◽

pp. 100-104

Author(s):

Gregory M. Blanton

Keyword(s):

Airway Equipment

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What do we need for airway management of adult casualties on the Primary Casualty Receiving Facility? A review of airway management on Role 3 Afloat

Journal of The Royal Naval Medical Service ◽

10.1136/jrnms-101-155 ◽

2015 ◽

Vol 101 (2) ◽

pp. 155-159

Author(s):

SJ Mercer ◽

J Read ◽

Maj S Sudheer ◽

JE Risdall ◽

D Conor

Keyword(s):

Airway Management ◽

Complex Trauma ◽

Case Mix ◽

Ct Scanner ◽

Royal Navy ◽

National Guidelines ◽

Current Configuration ◽

Airway Equipment ◽

Surgical Teams ◽

Maritime Environment

AbstractThe Primary Casualty Receiving Facility (PCRF) of the Royal Navy (RN) is currently based on Royal Fleet Auxiliary (RFA) ARGUS and provides a functioning hospital with surgical teams and a CT scanner (Role 3) within the maritime environment. The case mix could include complex trauma, critically ill patients returning to theatre several times, as well as non-battle injury procedures. This paper describes how we have used national guidelines, evidence from recent military experience, and the Clinical Guidelines for Operations (CGOs) to review and rationalise the airway equipment that is available and that would be required for the PCRF in its current configuration, whilst maintaining capability in a deployed setting.

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Airway Equipment and Difficult Airway Management During Pediatric Neurosurgery

10.1007/978-981-16-3376-8_5 ◽

2021 ◽

pp. 79-95

Author(s):

Satyen Parida ◽

Sandeep Kumar Mishra ◽

Arvind Kumar Arya

Keyword(s):

Airway Management ◽

Difficult Airway ◽

Pediatric Neurosurgery ◽

Difficult Airway Management ◽

Airway Equipment

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FOOSH—OUCH!

Pediatric Traumatic Emergencies ◽

10.1093/med/9780190946623.003.0018 ◽

2020 ◽

pp. 151-158

Author(s):

Victor Huang ◽

Nima Jalali ◽

Bryan McCarty ◽

Philipp J. Underwood

Keyword(s):

Side Effects ◽

Soft Tissue ◽

Soft Tissue Injuries ◽

Systemic Approach ◽

Supracondylar Fractures ◽

Relieve Pain ◽

Patient Cooperation ◽

Airway Equipment ◽

The Right ◽

Improve Patient

A twelve-year-old boy presents with right wrist pain after a fall onto outstretched hand (FOOSH). The injury was isolated to the right wrist, which was swollen, visibly deformed, but neurovascularly intact distally. Imaging revealed a distal radial and ulna fracture with dorsal displacement. Injuries after a FOOSH include physeal fractures, incomplete fractures, supracondylar fractures, and soft-tissue injuries. Open fractures and neurovascular compromise warrant emergent orthopedic consultation. Displaced fractures should be reduced in the ED and immobilized in a sugar tong splint. Local anesthetics and procedural sedation are important tools to relieve pain and improve patient cooperation. Due to the risks of sedation, physicians should have a systemic approach to evaluate the patient and prepare the monitoring and airway equipment. There are many different medications and routes available. It is important for the physician to be aware of the side effects and discuss this with the patient and parents.

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