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

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

3. 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

4. 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.

5. 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

6. 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

7. 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 ASA Practice Guidelines
What is a Difficult Airway?

9. #1

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

11. 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

12. # 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

13. 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

14. # 3

15. A tool is not a plan!!

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

17. “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

18. 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

19. Thank you for listening