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J U LY 2 0 1 4 | S U P P L E M E N T T O O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E
occurring or
resolving the
risks before they
arise. Here's how
the people at the
head of the table
anticipate, avoid
and address air-
way
complications.
Check the record
Can difficult airway situations be anticipated? In many cases, they can. Perhaps
the primary source of such insights is the patients' own charts. Good, thorough
documentation often notes if and when the patient has undergone a previous
procedure in your facility, and possibly even procedures performed at other
local facilities. If difficulties arose during these cases, it will list the details.
Review the documentation for all accounts of earlier anesthesia interactions,
especially for any related complications. It might be recorded, for instance, that
the patient underwent anesthesia the preceding year and presented a difficult
airway, for which 4 attempts and ultimately a video laryngoscope were required
before intubation was successful. Reading this, you can take note of which
provider attended the case and, considering their level of experience, prepare
yourself accordingly.
If documenting difficult airways in a patient's chart is not common at your
facility, it's definitely time to institute the practice for safety's sake. I've even
seen the inclusion of warning pages in charts, explaining the circumstances of
the difficulty. The patient can be given a copy of this page as well, to present to
surgeons and anesthesia providers in advance of any future procedures.
A I R W A Y M A N A G E M E N T
P
reparation goes a
long way in han-
dling potentially
difficult airway sit-
uations, whether it
is preventing emergencies from
AIRWAY ARSENAL Laryngeal mask
airways, both traditional and intu-
bating, should be part of an anes-
thesia provider's toolkit.
Pamela
Bevelhymer,
RN,
BSN
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