scholarly journals Survey of Airway Skills of Surgeons in Western Australia

2009 ◽  
Vol 37 (4) ◽  
pp. 630-633 ◽  
Author(s):  
R. H. Riley ◽  
T. Strang ◽  
S. Rao
Keyword(s):  
Airway Management ◽  
Difficult Airway ◽  
Western Australia ◽  
Life Support ◽  
Severe Trauma ◽  
Advanced Trauma Life Support ◽  
Early Management ◽  
Surgical Assistance ◽  
Surgical Airway ◽  
Failed Airway

Our objective was to survey all consultant surgeons, including obstetricians/gynaecologists, in the State of Western Australia to assess their experience with, and readiness to assist anaesthetists with a difficult or failed airway. Survey questionnaires were mailed to all surgeons registered in Western Australia (n=445). A total of 238 responses (53%) were received, mostly from general surgeons, obstetrician/gynaecologists and orthopaedic surgeons. Forty percent had provided non-surgical assistance with a difficult airway and 60% had assisted with a surgical airway. All ear, nose and throat surgeons who responded to the survey had assisted with an emergency surgical airway and 47 surgeons reported having performed six or more surgical airways. However, 26% of respondents had never performed a surgical airway and 37% did not feel confident in performing an urgent surgical airway. Seven percent of respondents reported witnessing a failed airway that resulted in death or neurological damage. Seventy percent of respondents had undergone formal training in tracheostomy and 26% had advanced trauma life support or early management of severe trauma training. These findings indicate that surgeons in Western Australia perform surgical airways infrequently and only occasionally assist anaesthetists with difficult airway management. However, some surgeons lack confidence and training in surgical airway management. Because anaesthetists cannot always rely on their surgical colleagues to provide a surgical airway during a crisis, we recommend that anaesthetists discuss airway management with their surgical colleagues for all patients with identified difficult airways and that anaesthesia training should include surgical airway management.

Emergency Surgical Airway Algorithm for Difficult Airway Management During the COVID-19 Pandemic

2021 ◽  
pp. 019459982098656
Author(s):  
Soham Roy ◽  
John D. Cramer ◽  
Carol Bier-Laning ◽  
Patrick A. Palmieri ◽  
Christopher H. Rassekh ◽  
...  
Keyword(s):  
Airway Management ◽  
Difficult Airway ◽  
Difficult Airway Management ◽  
Surgical Airway

scholarly journals Knowledge and Proficiency in Skills of Initial Trauma Management among Healthcare Personnel in Secondary Care

2020 ◽  
Vol 3 (1) ◽  
pp. 267-271
Author(s):  
HY Embu ◽  
SI Nuhu ◽  
SP Bishmang
Keyword(s):  
Airway Management ◽  
Respiratory Distress ◽  
Trauma Care ◽  
Secondary Care ◽  
Life Support ◽  
Healthcare Personnel ◽  
Advanced Trauma Life Support ◽  
Trauma Management ◽  
Management Skills ◽  
North Central

Advanced Trauma Life Support (ATLS) protocols aim to provide good trauma care by enhancing the skills of medical personnel all over the world and while this is well established in developed countries it does not appear to be so in developing countries. This study aims to assess the knowledge and proficiency in initial trauma management skills among health caregivers in some general/cottage hospitals in north central Nigeria. Questionnaires were developed to assess the knowledge and skills of care givers in airway management, respiratory distress and shock. The questionnaires were administered on caregivers involved in trauma care in some general/cottage hospitals that offer secondary care in a state in north-central Nigeria. There were 34 health workers who responded, 10 (29.41%) were doctors and 24(70.54%) were nurses. Their years of experience were from 2 to 35 years (median 14years). Ten (29.41%) had at least one training in ATLS in the past while 24(70.59%) had none. In assessing their management skills, 97.06% reported they were able to assess the airway, 88.24% could do chin lift, 73.53% jaw thrust while 91.18% were able to insert oral airway. Thirty-one (91.18%) were able to recognize respiratory distress, 88.24 were able to administer oxygen using facemask and 64.71% using nasal prong. Thirty (88.24%) could assess a patient for shock, 82.35% could splint fractures for haemorrhage control. Twenty-seven (79.41%) reported knowing parameters to monitor during resuscitation. We concluded that knowledge of airway management was high but proficiency and confidence in performing these skills were low.

scholarly journals (P1-62) The Risk Factors for Difficult or Failed Airway: A Prosepctive Cohor Study

2011 ◽  
Vol 26 (S1) ◽  
pp. s118-s118
Author(s):  
C. Hsu
Keyword(s):  
Risk Factors ◽  
Airway Management ◽  
Difficult Airway ◽  
Healthcare Providers ◽  
Positive Association ◽  
Daily Practice ◽  
Trauma Patients ◽  
Airway Trauma ◽  
Failed Airway ◽  
Airway Devices

The risk factors for difficult airway or failed airway: a prospective cohort study Airway management is always the first priority and time-treasures in critical ill-patients. Improper managementof difficult airway or resultant fail airway would bring poor prognosis to patients. We investigated the risk factors of difficult or fail airway from the multiple dimension of factors including patients, healthcare and airway devices. We enrolled 252 intubated patients, including 37 trauma patients, 55 patients (22%) with difficult airway, and 22 patients (8.7%) with fail airway. In analysis of risk factors of difficult airway, factors including obesity, short neck or thickness of soft tissue, facial deformities and oral-nasal bleeding have positive association with fail airway, but the seniority of healthcare providers had no effect. However, experienced healthcare providers have more success rate after the occurrence of fail airway. The most complications of fail airway include airway trauma and hypoxia. As compared with non-trauma patients, trauma patients have more episodes of fail airway, difficult airway, and use of RSI, rescue airway for fail airway, airway trauma and vomiting. Therefore, it is necessary to establish an easy and safe standard guideline in daily practice of difficult and urgent airway management for healthcare providers.

A simulator for training airway management in advanced trauma life support

2001 ◽  
Vol 1230 ◽  
pp. 218-224
Author(s):  
L. Thurfjell ◽  
J. McLaughlin ◽  
A. Liu ◽  
C. Kaufmann ◽  
G. Rolfsson
Keyword(s):  
Airway Management ◽  
Life Support ◽  
Advanced Trauma Life Support

scholarly journals A Cohort and Database Study of Airway Management in Patients Undergoing Thyroidectomy for Retrosternal Goitre

2014 ◽  
Vol 42 (6) ◽  
pp. 700-708 ◽  
Author(s):  
N. Gilfillan ◽  
C. M. Ball ◽  
P. S. Myles ◽  
J. Serpell ◽  
W. R. Johnson ◽  
...  
Keyword(s):  
Airway Management ◽  
Difficult Airway ◽  
General Anaesthesia ◽  
Thyroid Surgery ◽  
Good Evidence ◽  
Anaesthetic Induction ◽  
Tracheal Compression ◽  
Induction Technique ◽  
Failed Airway ◽  
Symptoms And Signs

Patients undergoing thyroid surgery with retrosternal goitre may raise concerns for the anaesthetist, especially airway management. We reviewed a multicentre prospective thyroid surgery database and extracted data for those patients with retrosternal goitre. Additionally, we reviewed the anaesthetic charts of patients with retrosternal goitre at our institution to identify the anaesthetic induction technique and airway management. Of 4572 patients in the database, 919 (20%) had a retrosternal goitre. Two cases of early postoperative tracheomalacia were reported, one in the retrosternal group. Despite some very large goitres, no patient required tracheostomy or cardiopulmonary bypass and there were no perioperative deaths. In the subset of 133 patients managed at our institution over six years, there were no major adverse anaesthetic outcomes and no patient had a failed airway or tracheomalacia. In the latter cohort, of 32 (24%) patients identified as having a potentially difficult airway, 17 underwent awake fibreoptic tracheal intubation, but two of these were abandoned and converted to intravenous induction and general anaesthesia. Eleven had inhalational induction; two of these were also abandoned and converted to intravenous induction and general anaesthesia. Of those suspected as having a difficult airway, 28 (87.5%) subsequently had direct laryngoscopy where the laryngeal inlet was clearly visible. We found no good evidence that thyroid surgery patients with retrosternal goitre, with or without symptoms and signs of tracheal compression, present the experienced anaesthetist with an airway that cannot be managed using conventional techniques. This does not preclude the need for multidisciplinary discussion and planning.

scholarly journals ¿ Caminamos hacia el manejo del videolaringoscopio como primera opción en una vía aérea difícil?

2020 ◽  
Vol 12 (7) ◽  
pp. 1
Author(s):  
Juan José Correa Barrera ◽  
Mónica San Juan Álvarez ◽  
Blanca Gómez Del Pulgar Vázquez ◽  
Gholamian Ovejero Soraya
Keyword(s):  
Decision Making ◽  
Tracheal Intubation ◽  
Airway Management ◽  
Difficult Airway ◽  
The Other ◽  
Optimal Decision ◽  
Difficult Airway Management ◽  
Toma De Decisiones ◽  
Failed Airway ◽  
Optimal Decision Making

Determinar los factores predictivos de una vía aérea difícil constituye un reto para el médico anestesiólogo. La mayoría de guías actuales, sitúan los videolaringoscopios como elementos de rescate de una vía aérea fallida, tras una laringoscopia tradicional óptima. Establecer un algoritmo que en base a unas características físicas, permita determinar qué pacientes se beneficiarán del uso del videolaringoscopio como primera opción, puede suponer una ventaja y una disminución en los problemas relacionados con la vía aérea. Por otra parte, establecer cuáles de estos factores predicen con más fuerza una dificultad con el videolaringoscopio, nos ayudará a realizar mejores planes de abordaje y una óptima toma de decisiones sobre una vía aérea difícil. Este algoritmo ha sido capaz de conseguir la intubación traqueal de todos los pacientes en los que se ha previsto una laringoscopia difícil. ABSTRACT Moving towards videolaryngoscopy handling as first option in difficult airway management? Determining the predictors of a difficult airway is a challenge for the anesthesiologist. Most current guides place videolaryngoscopes as recue elements of a failed airway, after an optimal traditional laryngoscopy. Establishing an algorithm which, based on physical charcteristics, allows to determine which patients will benefit from the use of videolaryngoscopy as a first option, may lead to a potential advantage and a net decrease in airway related problems. On the other hand, establishing which of those factors predict in a more reliable way a difficulty with the videolaryngoscopy, will contribute to make better plans of approach as well as an optimal decision making on a difficult airway. This algorithm has been able to achieve tracheal intubation of all patients for which a difficult laryngoscopy is expected.

Airway Management In The Emergency Department

2018 ◽  
Author(s):  
Garrett S. Pacheco ◽  
Bryan Wilson
Keyword(s):  
Airway Management ◽  
Difficult Airway ◽  
Rapid Sequence Intubation ◽  
Intubation Attempt ◽  
Emergency Airway Management ◽  
Emergency Airway ◽  
Airway Emergency ◽  
Rapid Sequence ◽  
First Pass ◽  
Surgical Airway

Emergency airway management has evolved tremendously since the onset of the specialty’s origin. Over the years, the importance of first-pass success and approach to the difficult airway were the primary challenges faced by emergency physicians. With the advent of video laryngoscopy, the rates of first-pass success continue to increase, and the effect of the anatomically difficult airway has begun to lessen. With advances in tools for airway management, the challenges have shifted to approaching optimal preoxygenation and correction of physiologic disturbances prior to any intubation attempt. This review discusses traditional rapid sequence intubation and advances in the field of emergency airway management.  This review contains 6 figures, 6 tables and 74 references Key words: difficult airway, emergency airway management, preoxygenation, surgical airway

Knowledge and Proficiency in Skills of Initial Trauma Management among Healthcare Personnel in Secondary Care

2020 ◽  
Vol 3 (1) ◽  
pp. 267-271
Author(s):  
HY Embu ◽  
SI Nuhu ◽  
SP Bishmang
Keyword(s):  
Airway Management ◽  
Respiratory Distress ◽  
Trauma Care ◽  
Secondary Care ◽  
Life Support ◽  
Healthcare Personnel ◽  
Advanced Trauma Life Support ◽  
Trauma Management ◽  
Management Skills ◽  
North Central

Advanced Trauma Life Support (ATLS) protocols aim to provide good trauma care by enhancing the skills of medical personnel all over the world and while this is well established in developed countries it does not appear to be so in developing countries. This study aims to assess the knowledge and proficiency in initial trauma management skills among health caregivers in some general/cottage hospitals in north central Nigeria. Questionnaires were developed to assess the knowledge and skills of care givers in airway management, respiratory distress and shock. The questionnaires were administered on caregivers involved in trauma care in some general/cottage hospitals that offer secondary care in a state in north-central Nigeria. There were 34 health workers who responded, 10 (29.41%) were doctors and 24(70.54%) were nurses. Their years of experience were from 2 to 35 years (median 14years). Ten (29.41%) had at least one training in ATLS in the past while 24(70.59%) had none. In assessing their management skills, 97.06% reported they were able to assess the airway, 88.24% could do chin lift, 73.53% jaw thrust while 91.18% were able to insert oral airway. Thirty-one (91.18%) were able to recognize respiratory distress, 88.24 were able to administer oxygen using facemask and 64.71% using nasal prong. Thirty (88.24%) could assess a patient for shock, 82.35% could splint fractures for haemorrhage control. Twenty-seven (79.41%) reported knowing parameters to monitor during resuscitation. We concluded that knowledge of airway management was high but proficiency and confidence in performing these skills were low.

Difficult Airway

2017 ◽  
Author(s):  
Romina G. Ilic
Keyword(s):  
Airway Management ◽  
Difficult Airway ◽  
Awake Intubation ◽  
Supraglottic Airway ◽  
Patient Evaluation ◽  
Advanced Airway ◽  
Supraglottic Airway Devices ◽  
Surgical Airway ◽  
Airway Exchange ◽  
Airway Devices

The difficult airway chapter focuses on preparing the clinician for a challenging airway. Management of both the expected, as well as the unexpected, difficult airway is critical to the care of the perioperative patient. Proper patient evaluation, organization, and preparation with a variety of airway tools are imperative to successfully securing the airway. The chapter reviews the difficult airway algorithm and discusses advanced airway techniques such as the use of awake intubation, airway exchange catheters, supraglottic airway devices, and surgical airway. Gaining familiarity with and using these advanced airway techniques in non-urgent situations will help ensure success when they are needed in emergencies.

scholarly journals Knowledge and Proficiency in Skills of Initial Trauma Management among Healthcare Personnel in Secondary Care

2020 ◽  
Vol 3 (1) ◽  
pp. 267-271
Author(s):  
HY Embu ◽  
SI Nuhu ◽  
SP Bishmang
Keyword(s):  
Airway Management ◽  
Respiratory Distress ◽  
Trauma Care ◽  
Secondary Care ◽  
Life Support ◽  
Healthcare Personnel ◽  
Advanced Trauma Life Support ◽  
Trauma Management ◽  
Management Skills ◽  
North Central

Advanced Trauma Life Support (ATLS) protocols aim to provide good trauma care by enhancing the skills of medical personnel all over the world and while this is well established in developed countries it does not appear to be so in developing countries. This study aims to assess the knowledge and proficiency in initial trauma management skills among health caregivers in some general/cottage hospitals in north central Nigeria. Questionnaires were developed to assess the knowledge and skills of care givers in airway management, respiratory distress and shock. The questionnaires were administered on caregivers involved in trauma care in some general/cottage hospitals that offer secondary care in a state in north-central Nigeria. There were 34 health workers who responded, 10 (29.41%) were doctors and 24(70.54%) were nurses. Their years of experience were from 2 to 35 years (median 14years). Ten (29.41%) had at least one training in ATLS in the past while 24(70.59%) had none. In assessing their management skills, 97.06% reported they were able to assess the airway, 88.24% could do chin lift, 73.53% jaw thrust while 91.18% were able to insert oral airway. Thirty-one (91.18%) were able to recognize respiratory distress, 88.24 were able to administer oxygen using facemask and 64.71% using nasal prong. Thirty (88.24%) could assess a patient for shock, 82.35% could splint fractures for haemorrhage control. Twenty-seven (79.41%) reported knowing parameters to monitor during resuscitation. We concluded that knowledge of airway management was high but proficiency and confidence in performing these skills were low.

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