Airway Leads and Airway Response Teams: Improving Delivery of Safer Airway Management?

Abstract

Purpose of Review Airway management remains a source of significant morbidity and mortality. This review considers recent summaries of complications and looks toward strategies to improve practice using a coordinated approach. Recent Findings A safety gap can exist between national recommendations and local practice. A lack of attention to end tidal carbon dioxide has repeatedly contributed to airway mismanagement. Clinicians must be trained in newer airway devices (videolaryngoscopes or supraglottic airways) to use them effectively. Time must be found to teach rarely performed skills (e.g., front-of-neck access). Both larger and smaller hospitals have benefitted from an airway lead or response team, coordinating education programs, ensuring the adoption of guidelines, standardizing equipment, and recognizing the role of human factors and ergonomics. Summary Even in the twenty-first century, the incidence of airway-related morbidity and mortality can be reduced, by an institutionally supported, coordinated approach to the whole process of airway care.

Simple steps towards improving safety in obstetric airway management

“…Standardisation of airway equipment, including videolaryngoscopes, has been strongly advocated across hospital organisations; [28][29][30] however, as trainees rotate between hospitals, consideration should be given to implementing this region-wide. Adopting a single device should increase the speed of skill acquisition and promote institutional familiarity, maximising effective device utilisation.…”

Code Critical Airway: A Collaborative Solution to a Catastrophic Problem

“…17 Indeed, in small and large institutions alike, airway response teams function to coordinate education, ensure the implementation of the most up-to-date guidelines, keep equipment available, and facilitate a team-approach in each encounter. 20 With the implementation of these programs, a decrease in the frequency of emergency surgical airways has been described, 12,19 as well as a trend toward a decrease in mortality. 12 Ultimately, our data demonstrates an improvement in patient outcomes as the hospital culture began to adopt the CCA system.…”

Design and Implementation of Airway Response Teams to Improve the Practice of Emergency Airway Management

“…Implementing the ART in an institution requires policy development, educating clinicians, maintaining and supplying equipment, tracking utilization, and reviewing practice for quality improvement. A multidisciplinary airway safety committee composed of clinicians who are invested in improving airway management should be established, with an individual designated as the airway lead, who can serve to coordinate ART implementation, manage ART related clinical issues, and act as the liaison between the ART and hospital leadership [ 50 ]. Performing an initial gap analysis is necessary to identify areas where improvements to airway practices are most needed [ 13 ].…”