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Cook, Tim; Woodall, N.; Frerk, C.; Benger, Jonathan

doi:10.1017/cbo9781107707542.019

Cited by 4 publications

(6 citation statements)

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“…While many reports encourage improvised devices,37–41 it has been shown that they are unlikely to be useful and can even cause harm 42. Competent needle cricothyrotomy and JV operation were not uniformly observed in our cohort overall, which is consistent with previously reported data 42.…”

Section: Discussionsupporting

confidence: 90%

Performance gaps and improvement plans from a 5-hospital simulation programme for anaesthesiology providers: a retrospective study

et al. 2017

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BackgroundSimulation is increasingly employed in healthcare provider education, but usage as a means of identifying system-wide practitioner gaps has been limited. We sought to determine whether practice gaps could be identified, and if meaningful improvement plans could result from a simulation course for anaesthesiology providers.MethodsOver a 2-year cycle, 288 anaesthesiologists and 67 certified registered nurse anaesthetists (CRNAs) participated in a 3.5 hour, malpractice insurer-mandated simulation course, encountering 4 scenarios. 5 anaesthesiology departments within 3 urban academic healthcare systems were represented. A real-time rater scored each individual on 12 critical performance items (CPIs) representing learning objectives for a given scenario. Participants completed a course satisfaction survey, a 1-month postcourse practice improvement plan (PIP) and a 6-month follow-up survey.ResultsAll recorded course data were retrospectively reviewed. Course satisfaction was generally positive (88–97% positive rating by item). 4231 individual CPIs were recorded (of a possible 4260 rateable), with a majority of participants demonstrating remediable gaps in medical/technical and non-technical skills (97% of groups had at least one instance of a remediable gap in communication/non-technical skills during at least one of the scenarios). 6 months following the course, 91% of respondents reported successfully implementing 1 or more of their PIPs. Improvements in equipment/environmental resources or personal knowledge domains were most often successful, and several individual reports demonstrated a positive impact on actual practice.ConclusionsThis professional liability insurer-initiated simulation course for 5 anaesthesiology departments was feasible to deliver and well received. Practice gaps were identified during the course and remediation of gaps, and/or application of new knowledge, skills and resources was reported by participants.

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Section: Discussionsupporting

confidence: 90%

Performance gaps and improvement plans from a 5-hospital simulation programme for anaesthesiology providers: a retrospective study

et al. 2017

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“…The Fourth National Audit Project of the Royal College of Anaesthetists had highlighted the underuse of AFOI in the management of difficult airways and pointed out that inappropriate sedation was a major cause leading to its failure. [ 1 ]…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic responses and safety of sedation following premedication with dexmedetomidine and fentanyl during fiberoptic-assisted intubation in patients with predicted difficult airway

Rajan¹,

Talukdar²,

Tosh³

et al. 2018

Anesth Essays Res

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Background:Awake fiberoptic intubation (AFOI) is the gold standard for the management of predicted difficult airway, and inappropriate sedation is a major cause leading to its failure.Aims:The primary objective was to compare the heart rate (HR) changes that accompany AFOI following sedation with dexmedetomidine and fentanyl. Secondary objectives included comparison of changes in blood pressure, patient comfort, ease of intubation, and degree of sedation.Settings and Designs:This prospective double-blinded randomized study was conducted in a tertiary care institution.Subjects and Methods:Forty patients with anticipated difficult airway requiring AFOI were included in the study. Group A received dexmedetomidine 1 μg/kg whereas Group B received fentanyl 2 μg/kg. After topical anesthesia of the airway, AFOI was performed.Statistical Analysis Used:Fisher's exact test, independent two-sample t-test, and Mann–Whitney U-test were used as applicable.Results:The hemodynamic parameters were comparable in both the groups except at 1 min postintubation when fentanyl group had significantly higher HR. There were lower alertness and muscle tone scores in dexmedetomidine group. Total comfort score was significantly higher in fentanyl group. Though more patients in dexmedetomidine group showed that no reaction to intubation and more patients in fentanyl had slight grimacing, the difference was insignificant. The ease of intubation was similar in both the groups.Conclusion:Though dexmedetomidine1 μg/kg and fentanyl 2 μg/kg premedication results in comparable hemodynamics and ease of intubation, in view of enhanced patient comfort, dexmedetomidine premedication is advantageous in patients with anticipated difficult airway undergoing AFOI.

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“…This network is now being developed. Departmental airway leads, a concept borne from the UK's 4th National Audit Project, 13 is a means of connecting a CPG to a clear point person at a local level. Airway leads are now present and working in the UK and New Zealand to translate knowledge, 14 and are a means for making CPG iterative and responsive to local requirements.…”

mentioning

confidence: 99%

In a forest of airway guidelines, it’s time to make a shared path

Duggan

2021

Can J Anesth/J Can Anesth

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Cited by 4 publications

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Performance gaps and improvement plans from a 5-hospital simulation programme for anaesthesiology providers: a retrospective study

Performance gaps and improvement plans from a 5-hospital simulation programme for anaesthesiology providers: a retrospective study

Hemodynamic responses and safety of sedation following premedication with dexmedetomidine and fentanyl during fiberoptic-assisted intubation in patients with predicted difficult airway

In a forest of airway guidelines, it’s time to make a shared path

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