Performance of emergency surgical front of neck airway access by head and neck surgeons, general surgeons, or anaesthetists: an in situ simulation study

British Journal of Anaesthesia

Volumn 123, Issue 5, 2019, Pages 696-703

  Groom, Peter ^a   Schofield, Louise ^a   Hettiarachchi, Natasha ^a   Pickard, Samuel ^a   Brown, Jeremy ^b   Sandars, John ^b   Morton, Ben ^a,c  

^a ROYAL LIVERPOOL AND BROADGREEN UNIVERSITY HOSPITALS NHS TRUST   (United Kingdom)

^b EDGE HILL UNIVERSITY   (United Kingdom)

^c LIVERPOOL SCHOOL OF TROPICAL MEDICINE   (United Kingdom)

Author keywords

airway obstruction; cannot intubate cannot oxygenate; front of neck access; high fidelity simulation training; surgical cricothyroidotomy; surgical training; tracheostomy

Indexed keywords

AIRWAY OBSTRUCTION; ANESTHESIST; ARTICLE; ASSISTED VENTILATION; CLINICAL COMPETENCE; COMPARATIVE STUDY; CONSULTATION; DENTAL SURGEON; EMERGENCY SURGERY; FRONT OF NECK AIRWAY TECHNIQUE; GENERAL PRACTITIONER; HIGH FIDELITY SIMULATION TRAINING; HUMAN; MEDICAL SPECIALIST; OPERATING ROOM PERSONNEL; OPERATION DURATION; PRIORITY JOURNAL; PROFESSIONAL KNOWLEDGE; QUALITATIVE ANALYSIS; RESPIRATORY TRACT INTUBATION; TRACHEOSTOMY; TRACHEOTOMY; UNITED KINGDOM; ADVERSE EVENT; ANESTHESIOLOGY; CRICOID CARTILAGE; EMERGENCY; ENDOTRACHEAL INTUBATION; ENGLAND; GENERAL SURGERY; PATIENT SIMULATION; PROCEDURES; RANDOMIZATION; RESPIRATION CONTROL; SURGERY; THYROID CARTILAGE; TREATMENT CONTRAINDICATION;

AIRWAY MANAGEMENT; ANESTHESIOLOGY; CLINICAL COMPETENCE; CONTRAINDICATIONS, PROCEDURE; CRICOID CARTILAGE; EMERGENCIES; ENGLAND; GENERAL SURGERY; HUMANS; INTUBATION, INTRATRACHEAL; PATIENT SIMULATION; RANDOM ALLOCATION; THYROID CARTILAGE; TRACHEOTOMY;

EID: 85071092797     PISSN: 00070912     EISSN: 14716771     Source Type: Journal    
DOI: 10.1016/j.bja.2019.07.011     Document Type: Article

References (20)

1. Cook TM, Woodall N, Frerk C. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society: Part 1. Anaesthesia. Br J Anaesth 2011; 106: 617-631
2. Frerk C, Mitchell VS, McNarry AF, et al. Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. Br J Anaesth 2015; 115: 827-848
3. Pracy JP, Brennan L, Cook TM, et al. Surgical intervention during a Can't Intubate Can't Oxygenate (CICO) event: emergency front-of-neck airway (FONA)? Clin Otolaryngol 2016; 41: 624-626
4. Mendonca C, Ahmad I, Sajayan A, et al. Front of neck access: a survey among anesthetists and surgeons. J Anaesthesiol Clin Pharmacol 2017; 33: 462-466
5. Lockey D, Crewdson K, Weaver A, Davies G. Observational study of the success rates of intubation and failed intubation airway rescue techniques in 7256 attempted intubations of trauma patients by pre-hospital physicians. Br J Anaesth 2014; 113: 220-225
6. Kyle T, le Clerc S, Thomas A, Greaves I, Whittaker V, Smith JE. The success of battlefield surgical airway insertion in severely injured military patients: a UK perspective. J R Army Med Corps 2016; 162: 460-464
7. Baker PA, O'Sullivan EP, Kristensen MS, Lockey D. The great airway debate: is the scalpel mightier than the cannula? Br J Anaesth 2016; 117: i17-i9
8. Hogg ES, Kinshuck AJ, Littley N, Lau A, Tandon S, Lancaster J. A high-fidelity, fully immersive simulation course to replicate ENT and head and neck emergencies. J Laryngol Otol 2019; 133: 115-118
9. Berwick RG, Gauntlett W, Silverio, SA, et al. A mixed-methods pilot study to evaluate a collaborative anaesthetic and surgical training package for emergency surgical cricothyroidotomy Anaesth Intensive Care 2019; in press
10. Berwick RM, Mercer SJ, Groom P. Evaluating the fidelity of a novel part-task trainer for emergency front of neck access training. BMJ Simul Technol Enhanced Learn 2018: 101-2
11. Ritchie J, Lewis J, Nicholls CM, Ormston R. Qualitative Research Practice: A Guide for Social Science Students and Researchers. 2nd Edn. London: Sage Publications, 2014
12. Cohen LM, Manion L, Morrison K. Research Methods in Education. 8th Edn. London: Routledge, 2018
13. Riley RH, Strang T, Rao S. Survey of airway skills of surgeons in Western Australia. Anaesth Intensive Care 2009; 37: 630-633
14. Greenland KB, Acott C, Segal R, Goulding G, Riley RH, Merry AF. Emergency surgical airway in life-threatening acute airway emergencies-why are we so reluctant to do it? Anaesth Intensive Care 2011; 39: 578-584
15. Malekzadeh S, Malloy KM, Chu EE, Tompkins J, Battista A, Deutsch ES. ORL emergencies boot camp: using simulation to onboard residents. Laryngoscope 2011; 121: 2114-2121
16. Timmermann A, Chrimes N, Hagberg CA. Need to consider human factors when determining first-line technique for emergency front-of-neck access. Br J Anaesth 2016; 117: 5-7
17. Awad Z, Pothier DD. Management of surgical airway emergencies by junior ENT staff: a telephone survey. J Laryngol Otol 2007; 121: 57-60
18. Mabry RL. An analysis of battlefield cricothyrotomy in Iraq and Afghanistan. J Spec Oper Med 2012; 12: 17-23
19. Fraser K, Wright B, Girard L, et al. Simulation training improves diagnostic performance on a real patient with similar clinical findings. Chest 2011; 139: 376-381
20. Rouhani MJ. In the face of increasing subspecialisation, how does the specialty ensure that the management of ENT emergencies is timely, appropriate and safe? J Laryngol Otol 2016; 130: 516-520