Narjes Hajer Naouar Anesthesia Technologist Anticipated Difficult Airway Management Algorithm For Anesthesia Technician Narjes Hajer Naouar Anesthesia Technologist

Preview Introduction Leadership and team work Role of the anesthesia technician The algorithm and its purpose Conclusion

Introduction Help to make decisions about health care Decisions could be adopted ,modified or rejected according to clinical needs and constraints Decisions are subject to revision as warranted by the evolution of medical knowledge, technology, and practice Facilitate the management of the difficult airway and to reduce the likelihood of adverse outcomes

Human Organization Loss of situational awareness. Humans can be the strongest or weakest part of a team. Human factors can create: Loss of situational awareness. Loss of perception and cognition. Fragmented teamwork. Loss of airway control.

Leadership And Team Work The key in crisis situations is to have clear communication Before starting any procedure, there should be a clear plan, known by everyone on the team There must be culture of listening The leader is essential to ensure that all the other points above can actually benefit the team

Anesthesia Technician Role Follows the instruction given by the anesthetist during the team brief Collects difficult airway cart & any other stated equipment Ask for help Remain with the anesthetist and patient all the time Assisting the anesthetist during all maneuvers according his needs Ability to troubleshoot any devices dysfunction

What is a Difficult Airway? “The clinical situation in which a conventionally trained anesthesiologist experiences difficulty with face mask ventilation of the upper airway, difficulty with tracheal intubation, or both.” Suggested definition from 2003 ASA Practice Guidelines What is a Difficult Airway?

#1

Evaluation of the airway Along with the Mallampati score , consider l l

Patient Consent Inform the pt/responsible person of special risks & procedures needed for management of difficult airway The uncooperative or pediatric patient may restrict the options

# 2 Pre-oxygenation: How much is enough? Good pre-O2: ETO2 > o.9 Two techniques common in use: Tidal volume breathing (TVB) of oxygen for 3–5 min Deep breaths (DB) 4 times within 0.5 min

Always have a 2nd trained person available Common Preparation Always have a 2nd trained person available SOAP-ME Suction Oxygen Airway Pharmacological Agent Monitors Equipment

# 3

A tool is not a plan!!

Airway Approach Algorithm (AAA) Prof. William H. Rosenblatt

“There is an uneasy combination of science and art in airway management, and much of our practice is based on anecdote and opinion.” Ian Calder, Anesthesiology 2007;107:171

Summary We should focus on ventilation and oxygenation in airway management Plans to manage the airway of a patient depend on many factors and situations , that’s why communication is very important All airway practitioners should modify their approaches to meet these challenges The creation of structure and teamwork for effective efficiency in an emergency situation

Thank you for listening