Communication in Airway Rescue
Feb 19, 2024
Clear, concise, safe.
It is well recognised that effective communication in airway rescue is vital to providing timely intervention and keeping your patient safe. Having a shared mental model, and using closed loop communication are two proven methods to improve patient safety. ✅🫵
Here they are in a nutshell:
1️⃣ Shared mental models:
The Vortex Approach is an example of a shared mental model for airway rescue. This means:
👉 The whole team knows the plan
👉 Team members can anticipate the next step
👉 Fixation error is reduced because team members can provide clear prompts
👉 The authority gradient is reduced so that anyone can speak up
In practice, it looks like this:
👉 “Is the patient paralysed?”
👉 “For your next attempt at intubation, would you like a bougie?”
👉 “The videolaryngoscope is ready”
👉 “This is your last attempt at LMA”
2️⃣ Closed loop communication:
Has three steps:
1️⃣ Instruction goes out
2️⃣ Person receiving instruction repeats it back or asks for clarification.
3️⃣ Person giving instruction corrects or confirms, closing the loop.
👉 It provides a safeguard from communication errors
👉 Gives early opportunity to correct misheard instructions
👉 Should always include the use of names so there is no confusion about who the request is for
In practice, it looks like this:
1️⃣ Anaesthetist: “cricoid pressure on”
2️⃣ Nurse: “cricoid pressure is on”
1️⃣ Anaesthetist: “Emily, can you grab the CMAC and set up the 4 blade”
2️⃣ Nurse: “Grabbing the CMAC 4 blade…. CMAC 4 blade is now ready”
How was the communication in your last airway rescue? 🤷♀️
Build knowledge ✅
Improve safety ✅
Ref: https://www.anzca.edu.au/getattachment/71f54974-314a-4d96-bef2-c03f39c8a8e9/PG61(A)-Guideline-for-management-of-evolving-airway-obstruction-transition-to-CICO-airway-emergency
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