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Communication about Shared Airways

closed loop communication communication shared airway team time-out teamwork Jun 24, 2024

Safe shared airway surgery requires a high degree of cooperation between all team members. Here’s what you need to know:

🌟 Preoperative 🌟
🔍 Clear and open communication:
The anaesthetic nurse should always feel comfortable asking the surgical team about airway management. Using clear and closed-loop communication is important in the setting of shared airway surgery.

🔍 Type of airway:
Even if you think you know the plan, confirm this with the anaesthetist and surgical team.

🔍 Access required:
Check if the surgical team has any specific requirements about positioning and access to the airway.

🔍 Anticipated problems:
During the Team Time-Out, check whether any team members have concerns about THIS patient or THIS procedure.

🌟 Intraoperative 🌟
🔍 Confirm airway type and communicate difficulties at intubation:
After intubation, confirm position with end-tidal CO2 and ensure the surgical team is aware of any difficulties encountered.

🔍 Remain vigilant for airway/ventilation issues:
Surgery in the airway can cause movement, kinking, or removal of the airway. Remain vigilant, and communicate any changes early.

🔍 Observe blood loss:
Keep an eye on bleeding during the surgery, and elicit the likelihood of postoperative bleeding.

🔍 Inspect airway prior extubation:
Directly inspect the airway, check for bleeding +/- throat pack removal.

🔍 Elicit any anticipated postoperative problems:
Discuss any concerns about the postoperative period with the anaesthetist and surgical team.

🌟 Postoperative 🌟
If unexpected problems occur in the recovery room, ensure all parties have been made aware.

✅ Build knowledge
✅ Improve safety

Ref: Shamji FM, Deslauriers J. Sharing the Airway: The Importance of Good Communication Between Anesthesiologist and Surgeon. Thorac Surg Clin. 2018 Aug;28(3):257-261. doi: 10.1016/j.thorsurg.2018.05.001. PMID: 30054062.

 

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