![]() The likelihood of a failed intubation should heighten the degree of preparedness for rescue ventilation and a cricothyroidotomy. If difficult direct laryngoscopy or face mask ventilation is anticipated, the difficult airway trolley should be moved to the bed space. ![]() Utilisation of such techniques should be reserved for experienced operators in an anticipated difficult intubation. Awake fibreoptic intubations can be very challenging in patients with deranged physiology. In attempt to improve emergent airway management we conducted a non-systematic review and devised a SOP for rapid sequence induction (RSI) of the critically ill.įollowing the appropriate assessment, extra equipment, senior help, surgical assistance or an awake technique may be appropriate. In a clinically challenging and stressful environment, standardised equipment and patient preparation will liberate extra bandwidth to maintain situational awareness and facilitate focus on patient care.Īs individuals, we may feel that our own practice is safe but we also have a responsibility to improve institutional practice and safety. Use of standardised equipment preparations and checklists are vital to limit human error while improving team communication and patient safety. In prehospital and military environments it is well recognised that the higher the acuity of the situation, the greater the need to remove individual procedural preferences and to adhere to a standard operating procedure (SOP). Intubation bundles have been shown to reduce immediate severe life-threatening complications associated with intubation of ICU patients. Īs a way of combating such issues, many clinicians have suggested the greater adoption of guidelines, checklists and standardised practice. The Fourth National Audit Project (NAP4) highlighted many potential issues with emergent airway management in the United Kingdom (UK), including inexperienced operators, inadequate equipment availability, poor planning and non-technical skills. When compared to the theatre setting, airway adverse events that result in death or brain damage are 30 and 60-fold more frequent in the Emergency Department (ED) and Intensive care unit (ICU), respectively. Critically ill patients requiring emergent airway management are at high risk of hypoxia and cardiovascular collapse due to a significant pathology, deranged physiology and iatrogenic causes.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |