Front of neck access: A survey among anesthetists and surgeons
Background and Aims: Emergency front of neck access (FONA) is the final step in a Can't Intubate–Can't Oxygenate (CICO) scenario. In view of maintaining simplicity and promoting standardized training, the 2015 Difficult Airway Society guidelines recommend surgical cricothyroidotomy using s...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2017-01-01
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| Series: | Journal of Anaesthesiology Clinical Pharmacology |
| Subjects: | |
| Online Access: | http://www.joacp.org/article.asp?issn=0970-9185;year=2017;volume=33;issue=4;spage=462;epage=466;aulast=Mendonca |
| _version_ | 1811225266275483648 |
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| author | Cyprian Mendonca Imran Ahmad Achuthapillai Sajayan Rathinavel Shanmugam Manu Sharma Will Tosh Emily Pallister Peter K Kimani |
| author_facet | Cyprian Mendonca Imran Ahmad Achuthapillai Sajayan Rathinavel Shanmugam Manu Sharma Will Tosh Emily Pallister Peter K Kimani |
| author_sort | Cyprian Mendonca |
| collection | DOAJ |
| description | Background and Aims: Emergency front of neck access (FONA) is the final step in a Can't Intubate–Can't Oxygenate (CICO) scenario. In view of maintaining simplicity and promoting standardized training, the 2015 Difficult Airway Society guidelines recommend surgical cricothyroidotomy using scalpel, bougie, and tube (SBT) as the preferred technique.
Material and Methods: We undertook a survey over a 2-week period to evaluate the knowledge and training, preferred rescue technique, and confidence in performing the SBT technique. Data were collected from both anesthetists and surgeons.
Results: One hundred and eighty-nine responses were collected across four hospitals in the United Kingdom. The majority of participants were anesthetists (55%). One hundred and eleven (59%) respondents were aware of the national guidelines (96.2% among anesthetists and 12.9% among surgeons). Only 71 (37.6%) respondents indicated that they had formal FONA training within the last one year. Seventy-five anesthetists (72.8%) knew that SBT equipment was readily available in their department, while most surgeons (81.2%) did not know what equipment available. One hundred and five (55.5%) respondents were confident in performing surgical cricothyroidotomy in a situation where the membrane was palpable and only in 33 (17.5%) where the cricothyroid membrane was not palpable.
Conclusion: This survey has demonstrated that despite evidence of good training for anesthetists in FONA, there are still shortfalls in the training and knowledge of our surgical colleagues. In an emergency, surgeons may be required to assist or secure an airway in a CICO situation. Regular multidisciplinary training of all clinicians working with anesthetized patients should be encouraged and supported. |
| first_indexed | 2024-04-12T09:04:10Z |
| format | Article |
| id | doaj.art-c7691a71df944eb3a7ad32ff9339c82f |
| institution | Directory Open Access Journal |
| issn | 0970-9185 |
| language | English |
| last_indexed | 2024-04-12T09:04:10Z |
| publishDate | 2017-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Anaesthesiology Clinical Pharmacology |
| spelling | doaj.art-c7691a71df944eb3a7ad32ff9339c82f2022-12-22T03:39:09ZengWolters Kluwer Medknow PublicationsJournal of Anaesthesiology Clinical Pharmacology0970-91852017-01-0133446246610.4103/joacp.JOACP_109_17Front of neck access: A survey among anesthetists and surgeonsCyprian MendoncaImran AhmadAchuthapillai SajayanRathinavel ShanmugamManu SharmaWill ToshEmily PallisterPeter K KimaniBackground and Aims: Emergency front of neck access (FONA) is the final step in a Can't Intubate–Can't Oxygenate (CICO) scenario. In view of maintaining simplicity and promoting standardized training, the 2015 Difficult Airway Society guidelines recommend surgical cricothyroidotomy using scalpel, bougie, and tube (SBT) as the preferred technique. Material and Methods: We undertook a survey over a 2-week period to evaluate the knowledge and training, preferred rescue technique, and confidence in performing the SBT technique. Data were collected from both anesthetists and surgeons. Results: One hundred and eighty-nine responses were collected across four hospitals in the United Kingdom. The majority of participants were anesthetists (55%). One hundred and eleven (59%) respondents were aware of the national guidelines (96.2% among anesthetists and 12.9% among surgeons). Only 71 (37.6%) respondents indicated that they had formal FONA training within the last one year. Seventy-five anesthetists (72.8%) knew that SBT equipment was readily available in their department, while most surgeons (81.2%) did not know what equipment available. One hundred and five (55.5%) respondents were confident in performing surgical cricothyroidotomy in a situation where the membrane was palpable and only in 33 (17.5%) where the cricothyroid membrane was not palpable. Conclusion: This survey has demonstrated that despite evidence of good training for anesthetists in FONA, there are still shortfalls in the training and knowledge of our surgical colleagues. In an emergency, surgeons may be required to assist or secure an airway in a CICO situation. Regular multidisciplinary training of all clinicians working with anesthetized patients should be encouraged and supported.http://www.joacp.org/article.asp?issn=0970-9185;year=2017;volume=33;issue=4;spage=462;epage=466;aulast=MendoncaAirway managementanesthetistssurgeonssurvey and questionnairestracheostomy |
| spellingShingle | Cyprian Mendonca Imran Ahmad Achuthapillai Sajayan Rathinavel Shanmugam Manu Sharma Will Tosh Emily Pallister Peter K Kimani Front of neck access: A survey among anesthetists and surgeons Journal of Anaesthesiology Clinical Pharmacology Airway management anesthetists surgeons survey and questionnaires tracheostomy |
| title | Front of neck access: A survey among anesthetists and surgeons |
| title_full | Front of neck access: A survey among anesthetists and surgeons |
| title_fullStr | Front of neck access: A survey among anesthetists and surgeons |
| title_full_unstemmed | Front of neck access: A survey among anesthetists and surgeons |
| title_short | Front of neck access: A survey among anesthetists and surgeons |
| title_sort | front of neck access a survey among anesthetists and surgeons |
| topic | Airway management anesthetists surgeons survey and questionnaires tracheostomy |
| url | http://www.joacp.org/article.asp?issn=0970-9185;year=2017;volume=33;issue=4;spage=462;epage=466;aulast=Mendonca |
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