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Journal of Clinical Monitoring and... Apr 2022
Review
Topics: Airway Management; Humans; Intubation, Intratracheal
PubMed: 35262837
DOI: 10.1007/s10877-022-00839-9 -
BioMed Research International 2015
Topics: Airway Management; Airway Resistance; Emergency Medicine; Humans; Intubation, Intratracheal; Respiration, Artificial
PubMed: 26199941
DOI: 10.1155/2015/425715 -
British Journal of Anaesthesia Feb 2022We outline the history, implementation and clinical impact of the formation of an Airway Lead Network. Although recommendations to improve patient safety in airway...
We outline the history, implementation and clinical impact of the formation of an Airway Lead Network. Although recommendations to improve patient safety in airway management are published and revised regularly, uniform implementation of such guidelines are applied sporadically throughout the hospital and prehospital settings. The primary roles of an Airway Lead are to ensure supply, quality and storage of airway equipment, promote the use of current practice guidelines as well as the organisation of training and audits. Locally, the Airway Lead may chair a multi-disciplinary airway committee within their organisation; an Airway Lead Network enables Airway Leads to share common problems and solutions to promote optimal airway management on a national level. Support from governing bodies is an essential part of this structure.
Topics: Airway Management; Hospitals; Humans; Patient Safety; Practice Guidelines as Topic
PubMed: 34893313
DOI: 10.1016/j.bja.2021.11.013 -
Current Opinion in Anaesthesiology Dec 2017Successful and sustainable training and learning of the management of difficult and normal airway is essential for all clinically active anesthesiologists. We emphasize... (Review)
Review
PURPOSE OF REVIEW
Successful and sustainable training and learning of the management of difficult and normal airway is essential for all clinically active anesthesiologists. We emphasize the importance of a continuously updated learning and training environment based on actual knowledge, best available equipment, standardized procedures, and educational theory.
RECENT FINDINGS
In the past, most of the training were based on 'learning by doing' under the supervision of superiors or experienced colleagues. This has been recognized as insufficient and training has evolved to its recent level by structuring it into technical, methodological, and behavioral components. Additionally, a large part of it has been shifted away from learning on patients to simulated scenarios in designated environments. The contents, structure, components, and succession of components have been refined according to the steadily evolving and available instruments. Increasingly, team interaction and behavioral aspects gained more attention and became part of standardized education units that are tailored to the learners' clinical role and level of experience.
SUMMARY
We present the details of the Zurich Airway Training and Simulation program, which has been constantly updated to the actual state of knowledge and available equipment.
Topics: Airway Management; Anesthesiology; Clinical Competence; Communication; Educational Measurement; Feedback; Humans; Simulation Training
PubMed: 28957878
DOI: 10.1097/ACO.0000000000000523 -
Critical Care (London, England) Aug 2018After cardiac arrest a combination of basic and advanced airway and ventilation techniques are used during cardiopulmonary resuscitation (CPR) and after a return of... (Review)
Review
After cardiac arrest a combination of basic and advanced airway and ventilation techniques are used during cardiopulmonary resuscitation (CPR) and after a return of spontaneous circulation (ROSC). The optimal combination of airway techniques, oxygenation and ventilation is uncertain. Current guidelines are based predominantly on evidence from observational studies and expert consensus; recent and ongoing randomised controlled trials should provide further information. This narrative review describes the current evidence, including the relative roles of basic and advanced (supraglottic airways and tracheal intubation) airways, oxygenation and ventilation targets during CPR and after ROSC in adults. Current evidence supports a stepwise approach to airway management based on patient factors, rescuer skills and the stage of resuscitation. During CPR, rescuers should provide the maximum feasible inspired oxygen and use waveform capnography once an advanced airway is in place. After ROSC, rescuers should titrate inspired oxygen and ventilation to achieve normal oxygen and carbon dioxide targets.
Topics: Airway Management; Cardiopulmonary Resuscitation; Heart Arrest; Humans; Respiration, Artificial; Resuscitation
PubMed: 30111343
DOI: 10.1186/s13054-018-2121-y -
BioMed Research International 2015Pediatric airway management is a challenge in routine anesthesia practice. Any airway-related complication due to improper procedure can have catastrophic consequences... (Review)
Review
Pediatric airway management is a challenge in routine anesthesia practice. Any airway-related complication due to improper procedure can have catastrophic consequences in pediatric patients. The authors reviewed the current relevant literature using the following data bases: Google Scholar, PubMed, Medline (OVID SP), and Dynamed, and the following keywords: Airway/s, Children, Pediatric, Difficult Airways, and Controversies. From a summary of the data, we identified several controversies: difficult airway prediction, difficult airway management, cuffed versus uncuffed endotracheal tubes for securing pediatric airways, rapid sequence induction (RSI), laryngeal mask versus endotracheal tube, and extubation timing. The data show that pediatric anesthesia practice in perioperative airway management is currently lacking the strong evidence-based medicine (EBM) data that is available for adult subpopulations. A number of procedural steps in airway management are derived only from adult populations. However, the objective is the same irrespective of patient age: proper securing of the airway and oxygenation of the patient.
Topics: Airway Management; Anesthesia, General; Child; Evidence-Based Medicine; Humans; Intubation, Intratracheal; Laryngeal Masks; Pediatrics; Perioperative Care
PubMed: 26759809
DOI: 10.1155/2015/368761 -
British Journal of Anaesthesia Aug 2014Advanced airway management is one of the most controversial areas of pre-hospital trauma care and is carried out by different providers using different techniques in... (Review)
Review
Advanced airway management is one of the most controversial areas of pre-hospital trauma care and is carried out by different providers using different techniques in different Emergency Medical Services systems. Pre-hospital anaesthesia is the standard of care for trauma patients arriving in the emergency department with airway compromise. A small proportion of severely injured patients who cannot be managed with basic airway management require pre-hospital anaesthesia to avoid death or hypoxic brain injury. The evidence base for advanced airway management is inconsistent, contradictory and rarely reports all key data. There is evidence that poorly performed advanced airway management is harmful and that less-experienced providers have higher intubation failure rates and complication rates. International guidelines carry many common messages about the system requirements for the practice of advanced airway management. Pre-hospital rapid sequence induction (RSI) should be practiced to the same standard as emergency department RSI. Many in-hospital standards such as monitoring, equipment, and provider competence can be achieved. Pre-hospital and emergency in-hospital RSI has been modified from standard RSI techniques to improve patient safety, physiological disturbance, and practicality. Examples include the use of opioids and long-acting neuromuscular blocking agents, ventilation before intubation, and the early release of cricoid pressure to improve laryngoscopic view. Pre-hospital RSI is indicated in a small proportion of trauma patients. Where pre-hospital anaesthesia cannot be carried out to a high standard by competent providers, excellent quality basic airway management should be the mainstay of management.
Topics: Airway Management; Anesthesia; Anesthetics; Cricoid Cartilage; Delivery of Health Care; Emergency Medical Services; Guidelines as Topic; Humans; Wounds and Injuries
PubMed: 25038153
DOI: 10.1093/bja/aeu205 -
Anesthesiology Mar 2018
Topics: Airway Management; Anesthesia, Local; Anesthetics; Humans; Intubation, Intratracheal; Patient Safety
PubMed: 29324483
DOI: 10.1097/ALN.0000000000002075 -
Intensive Care Medicine Dec 2017
Topics: Airway Management; Humans; Intensive Care Units; Intubation, Intratracheal; Monitoring, Physiologic; Respiration, Artificial; Respiratory Insufficiency
PubMed: 29082415
DOI: 10.1007/s00134-017-4982-y -
British Journal of Anaesthesia Jul 2020
Topics: Airway Management; Intubation, Intratracheal; Laryngoscopy; Space Flight; Weightlessness
PubMed: 31918846
DOI: 10.1016/j.bja.2019.12.002