Throat Packs

airway management bleeding airway ent safety shared airway Jul 08, 2024

🌟 What and Why 🌟
A throat pack is a ribbon of gauze placed in the throat during surgical procedures to prevent blood, saliva, and other debris from entering the airway or digestive tract. These packs are particularly useful in oral, maxillofacial, and ENT surgeries where there is a high risk of contamination and aspiration. By maintaining a clear surgical field and protecting the airway, throat packs enhance patient safety and surgical precision. The throat pack contains an “X-ray” strip and is attached to a cotton string.

🔍 Intraoperative Considerations: 🔍
During the surgery, it is crucial to ensure that the throat pack is appropriately sized and positioned to avoid pressure or impaired venous drainage. The pack should be moistened with sterile saline to reduce friction and potential tissue damage. A throat pack is part of the surgical count, so closed-loop communication during insertion is essential. If your department uses throat pack stickers, adhere to this policy. The surgical team must communicate clearly about the presence of the pack to avoid the dangerous situation of a retained throat pack.

🌟 Postoperative Considerations: 🌟
🔺REMOVE: A throat pack must ALWAYS be removed before extubation, and it should never leave the operating theatre.
🔺INSPECT: Inspection of the airway after removal is important to check for clots, bleeding, or debris.
🔺COMMUNICATE: Communicate with your team and the team leader to ensure it is included in the surgical count. Hand over to the recovery nurse that the pack has been removed.
🔺DOCUMENT: Removal should be documented in the anaesthetic record.

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Ref: Turner, Grant, 'Ear, nose and throat surgery', in Rachel Freedman, and others (eds), Oxford Handbook of Anaesthesia, 5 edn, Oxford Medical Handbooks (Oxford, 2022; online edn, Oxford Academic, 1 Nov. 2021), accessed 13 June 2024.

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