Man vs. manikin revisited - the ethical boundaries of simulating difficult airways in patients

Sugammadex: when should we be giving it?

“…This figure is below the survival rates achieved in other countries, but, if it could be increased to 10-11%, a further 1000 lives a year could be saved in England [2]. The OHCA steering group aims to achieve this by addressing all aspects of the chain of survival pathway for victims of OHCA, and to this end has published its national framework 'Resuscitation to Recovery' in March 2017 [1]. This single consensus document outlines a pathway based on best scientific evidence, national and international guidance, and expert opinion [3,4].…”

“…Withdrawal of treatment after devastating brain injury: post-cardiac arrest pathways lead in best practice Every year in England, cardiopulmonary resuscitation (CPR) is attempted on about 30,000 people suffering an out of hospital cardiac arrest (OHCA) [1]. Return of spontaneous circulation (ROSC) is achieved in approximately 25%, and 7-8% of those in whom resuscitation is attempted will leave hospital alive.…”

Definitions of anaesthetic technique and the implications for clinical research

“…Two-thirds of respondents to a Scandinavian survey stated that they would consent to have their trachea intubated by a trainee while under general anaesthesia. The absence of clinical urgency also diminishes the human factor elements of a difficult airway [4]. Of the 30% who refused consent, 72 were afraid of injury, 57 would agree to serve as a training object for doctors but not medical students, 51 did not want to be a 'guinea pig', and 90 gave no reason [3].…”

“…However, as most anaesthetists agree that teaching airway skills on manikins without follow-up clinical training is insufficient [3,4], learning must also occur on patients and will apply throughout our careers. Students and nonspecialists, such as first-responders, must have sufficient airway management skills to provide a lifesaving service if called upon to do so.…”

Consensus on ethics in airway research – a reply

“…Unfortunately, the authors seem to have misunderstood the purpose of our editorial [2] and the scope of the CARE guidelines proposed therein. Our intention was to describe some of the ethical issues surrounding patient recruitment and airway interventions involving patients (as opposed to manikin-based studies) and to provide a basic framework to researchers and institutional review boards by which patient risk and morbidity could potentially be reduced.…”