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L H Lundstrom - One of the best experts on this subject based on the ideXlab platform.
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emergency Surgical Airway Management in denmark a cohort study of 452 461 patients registered in the danish anaesthesia database
BJA: British Journal of Anaesthesia, 2016Co-Authors: C V Rosenstock, A K Norskov, Jorn Wetterslev, L H LundstromAbstract:Abstract Background The emergency Surgical Airway (ESA) is the final option in difficult Airway Management. We identified ESA procedures registered in the Danish Anaesthesia Database (DAD) and described the performed Airway Management. Methods We extracted a cohort of 452 461 adult patients undergoing general anaesthesia and tracheal intubation from the DAD from June 1, 2008 to March 15, 2014. Difficult Airway Management involving an ESA was retrieved for analysis and compared with hospitals files. Two independent reviewers evaluated Airway Management according to the ASAs’2003 practice guideline for difficult Airway Management. Results In the DAD cohort 27 out of 452 461 patients had an ESA representing an incidence of 0.06 events per thousand (95% CI; 0.04 to 0.08). A total of 12 149/452 461 patients underwent Ear-Nose and Throat (ENT) surgery, giving an ESA incidence among ENT patients of 1.6 events per thousand (95% CI; 1.0–2.4). A Supraglottic Airway Device and/or the administration of a neuromuscular blocking agent before ESA were used as a rescue in 6/27 and 13/27 of the patients, respectively. In 19/27 patients ENT surgeons performed the ESA's and anaesthetists attempted 6/27 of the ESAs of which three failed. Reviewers evaluated Airway Management as satisfactory in 10/27 patients. Conclusions The incidence of ESA in the DAD cohort was 0.06 events per thousand. Among ENT patients, the ESA Incidence was 1.6 events per thousand. Airway Management was evaluated as satisfactory for 10/27 of the patients. ESA performed by anaesthetists failed in half of the patients.
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Emergency Surgical Airway Management in Denmark: a cohort study of 452 461 patients registered in the Danish Anaesthesia Database.
British journal of anaesthesia, 2016Co-Authors: C V Rosenstock, A K Norskov, Jorn Wetterslev, L H LundstromAbstract:The emergency Surgical Airway (ESA) is the final option in difficult Airway Management. We identified ESA procedures registered in the Danish Anaesthesia Database (DAD) and described the performed Airway Management. We extracted a cohort of 452 461 adult patients undergoing general anaesthesia and tracheal intubation from the DAD from June 1, 2008 to March 15, 2014. Difficult Airway Management involving an ESA was retrieved for analysis and compared with hospitals files. Two independent reviewers evaluated Airway Management according to the ASAs'2003 practice guideline for difficult Airway Management. In the DAD cohort 27 out of 452 461 patients had an ESA representing an incidence of 0.06 events per thousand (95% CI; 0.04 to 0.08). A total of 12 149/452 461 patients underwent Ear-Nose and Throat (ENT) surgery, giving an ESA incidence among ENT patients of 1.6 events per thousand (95% CI; 1.0-2.4). A Supraglottic Airway Device and/or the administration of a neuromuscular blocking agent before ESA were used as a rescue in 6/27 and 13/27 of the patients, respectively. In 19/27 patients ENT surgeons performed the ESA's and anaesthetists attempted 6/27 of the ESAs of which three failed. Reviewers evaluated Airway Management as satisfactory in 10/27 patients. The incidence of ESA in the DAD cohort was 0.06 events per thousand. Among ENT patients, the ESA Incidence was 1.6 events per thousand. Airway Management was evaluated as satisfactory for 10/27 of the patients. ESA performed by anaesthetists failed in half of the patients. © The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Paul S Pagel - One of the best experts on this subject based on the ideXlab platform.
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who teaches Surgical Airway Management and how do they teach it a survey of united states anesthesiology training programs
Journal of Clinical Anesthesia, 2011Co-Authors: Elena J Holak, Olga Kaslow, Paul S PagelAbstract:Abstract Study Objective To determine the methods used to teach Surgical Airway Management to residents. Design Electronic mail survey instrument. Setting Academic medical center. Participants 82 (of a possible 132) United States residency program directors. Measurements Data including whether instruction in Surgical Airway Management was provided, which methods were used, whether these teaching methods have changed since the subject was first examined, were recorded. The number of residents in each program represented by a respondent also was recorded. Main Results The survey response rate was 62% (82 of 132). Seventy-two respondents (88%) reported that education in Surgical Airway Management was part of their curriculum. Practice on a mannequin was the most common form of instruction (57%), followed by traditional didactic teaching (31%), a cadaver workshop or a large animal laboratory (29%), human patient simulator training (24%), and supply of subject-specific reading materials alone (3%). Forty-seven programs (65%) taught Surgical Airway Management using a single method, whereas the remainder (35%) incorporated more than one approach. Training experience was dependent on the program size. The top one quarter of the programs in size (67 ± 10 residents) were more likely to use a multimodal approach (48%) and a cadaver workshop or large animal laboratory (38%). Conclusions The majority of anesthesiology training programs accredited by the Accreditation Council for Graduate Medical Education provide some form of skill-based instruction in Surgical Airway Management for their residents.
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Who teaches Surgical Airway Management and how do they teach it? A survey of United States anesthesiology training programs
Journal of Clinical Anesthesia, 2011Co-Authors: Elena J Holak, Olga Kaslow, Paul S PagelAbstract:Abstract Study Objective To determine the methods used to teach Surgical Airway Management to residents. Design Electronic mail survey instrument. Setting Academic medical center. Participants 82 (of a possible 132) United States residency program directors. Measurements Data including whether instruction in Surgical Airway Management was provided, which methods were used, whether these teaching methods have changed since the subject was first examined, were recorded. The number of residents in each program represented by a respondent also was recorded. Main Results The survey response rate was 62% (82 of 132). Seventy-two respondents (88%) reported that education in Surgical Airway Management was part of their curriculum. Practice on a mannequin was the most common form of instruction (57%), followed by traditional didactic teaching (31%), a cadaver workshop or a large animal laboratory (29%), human patient simulator training (24%), and supply of subject-specific reading materials alone (3%). Forty-seven programs (65%) taught Surgical Airway Management using a single method, whereas the remainder (35%) incorporated more than one approach. Training experience was dependent on the program size. The top one quarter of the programs in size (67 ± 10 residents) were more likely to use a multimodal approach (48%) and a cadaver workshop or large animal laboratory (38%). Conclusions The majority of anesthesiology training programs accredited by the Accreditation Council for Graduate Medical Education provide some form of skill-based instruction in Surgical Airway Management for their residents.
C V Rosenstock - One of the best experts on this subject based on the ideXlab platform.
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emergency Surgical Airway Management in denmark a cohort study of 452 461 patients registered in the danish anaesthesia database
BJA: British Journal of Anaesthesia, 2016Co-Authors: C V Rosenstock, A K Norskov, Jorn Wetterslev, L H LundstromAbstract:Abstract Background The emergency Surgical Airway (ESA) is the final option in difficult Airway Management. We identified ESA procedures registered in the Danish Anaesthesia Database (DAD) and described the performed Airway Management. Methods We extracted a cohort of 452 461 adult patients undergoing general anaesthesia and tracheal intubation from the DAD from June 1, 2008 to March 15, 2014. Difficult Airway Management involving an ESA was retrieved for analysis and compared with hospitals files. Two independent reviewers evaluated Airway Management according to the ASAs’2003 practice guideline for difficult Airway Management. Results In the DAD cohort 27 out of 452 461 patients had an ESA representing an incidence of 0.06 events per thousand (95% CI; 0.04 to 0.08). A total of 12 149/452 461 patients underwent Ear-Nose and Throat (ENT) surgery, giving an ESA incidence among ENT patients of 1.6 events per thousand (95% CI; 1.0–2.4). A Supraglottic Airway Device and/or the administration of a neuromuscular blocking agent before ESA were used as a rescue in 6/27 and 13/27 of the patients, respectively. In 19/27 patients ENT surgeons performed the ESA's and anaesthetists attempted 6/27 of the ESAs of which three failed. Reviewers evaluated Airway Management as satisfactory in 10/27 patients. Conclusions The incidence of ESA in the DAD cohort was 0.06 events per thousand. Among ENT patients, the ESA Incidence was 1.6 events per thousand. Airway Management was evaluated as satisfactory for 10/27 of the patients. ESA performed by anaesthetists failed in half of the patients.
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Emergency Surgical Airway Management in Denmark: a cohort study of 452 461 patients registered in the Danish Anaesthesia Database.
British journal of anaesthesia, 2016Co-Authors: C V Rosenstock, A K Norskov, Jorn Wetterslev, L H LundstromAbstract:The emergency Surgical Airway (ESA) is the final option in difficult Airway Management. We identified ESA procedures registered in the Danish Anaesthesia Database (DAD) and described the performed Airway Management. We extracted a cohort of 452 461 adult patients undergoing general anaesthesia and tracheal intubation from the DAD from June 1, 2008 to March 15, 2014. Difficult Airway Management involving an ESA was retrieved for analysis and compared with hospitals files. Two independent reviewers evaluated Airway Management according to the ASAs'2003 practice guideline for difficult Airway Management. In the DAD cohort 27 out of 452 461 patients had an ESA representing an incidence of 0.06 events per thousand (95% CI; 0.04 to 0.08). A total of 12 149/452 461 patients underwent Ear-Nose and Throat (ENT) surgery, giving an ESA incidence among ENT patients of 1.6 events per thousand (95% CI; 1.0-2.4). A Supraglottic Airway Device and/or the administration of a neuromuscular blocking agent before ESA were used as a rescue in 6/27 and 13/27 of the patients, respectively. In 19/27 patients ENT surgeons performed the ESA's and anaesthetists attempted 6/27 of the ESAs of which three failed. Reviewers evaluated Airway Management as satisfactory in 10/27 patients. The incidence of ESA in the DAD cohort was 0.06 events per thousand. Among ENT patients, the ESA Incidence was 1.6 events per thousand. Airway Management was evaluated as satisfactory for 10/27 of the patients. ESA performed by anaesthetists failed in half of the patients. © The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Elena J Holak - One of the best experts on this subject based on the ideXlab platform.
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who teaches Surgical Airway Management and how do they teach it a survey of united states anesthesiology training programs
Journal of Clinical Anesthesia, 2011Co-Authors: Elena J Holak, Olga Kaslow, Paul S PagelAbstract:Abstract Study Objective To determine the methods used to teach Surgical Airway Management to residents. Design Electronic mail survey instrument. Setting Academic medical center. Participants 82 (of a possible 132) United States residency program directors. Measurements Data including whether instruction in Surgical Airway Management was provided, which methods were used, whether these teaching methods have changed since the subject was first examined, were recorded. The number of residents in each program represented by a respondent also was recorded. Main Results The survey response rate was 62% (82 of 132). Seventy-two respondents (88%) reported that education in Surgical Airway Management was part of their curriculum. Practice on a mannequin was the most common form of instruction (57%), followed by traditional didactic teaching (31%), a cadaver workshop or a large animal laboratory (29%), human patient simulator training (24%), and supply of subject-specific reading materials alone (3%). Forty-seven programs (65%) taught Surgical Airway Management using a single method, whereas the remainder (35%) incorporated more than one approach. Training experience was dependent on the program size. The top one quarter of the programs in size (67 ± 10 residents) were more likely to use a multimodal approach (48%) and a cadaver workshop or large animal laboratory (38%). Conclusions The majority of anesthesiology training programs accredited by the Accreditation Council for Graduate Medical Education provide some form of skill-based instruction in Surgical Airway Management for their residents.
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Who teaches Surgical Airway Management and how do they teach it? A survey of United States anesthesiology training programs
Journal of Clinical Anesthesia, 2011Co-Authors: Elena J Holak, Olga Kaslow, Paul S PagelAbstract:Abstract Study Objective To determine the methods used to teach Surgical Airway Management to residents. Design Electronic mail survey instrument. Setting Academic medical center. Participants 82 (of a possible 132) United States residency program directors. Measurements Data including whether instruction in Surgical Airway Management was provided, which methods were used, whether these teaching methods have changed since the subject was first examined, were recorded. The number of residents in each program represented by a respondent also was recorded. Main Results The survey response rate was 62% (82 of 132). Seventy-two respondents (88%) reported that education in Surgical Airway Management was part of their curriculum. Practice on a mannequin was the most common form of instruction (57%), followed by traditional didactic teaching (31%), a cadaver workshop or a large animal laboratory (29%), human patient simulator training (24%), and supply of subject-specific reading materials alone (3%). Forty-seven programs (65%) taught Surgical Airway Management using a single method, whereas the remainder (35%) incorporated more than one approach. Training experience was dependent on the program size. The top one quarter of the programs in size (67 ± 10 residents) were more likely to use a multimodal approach (48%) and a cadaver workshop or large animal laboratory (38%). Conclusions The majority of anesthesiology training programs accredited by the Accreditation Council for Graduate Medical Education provide some form of skill-based instruction in Surgical Airway Management for their residents.
David Jaslow - One of the best experts on this subject based on the ideXlab platform.
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out of hospital Surgical Airway Management does scope of practice equal actual practice
Western Journal of Emergency Medicine, 2016Co-Authors: Molly Furin, Melissa Kohn, Ryan Overberger, David JaslowAbstract:Introduction: Pennsylvania, among other states, includes Surgical Airway Management, or cricothyrotomy, within the paramedic scope of practice. However, there is scant literature that evaluates paramedic perception of clinical competency in cricothyrotomy. The goal of this project is to assess clinical exposure, education and self-perceived competency of ground paramedics in cricothyrotomy. Methods: Eighty-six paramedics employed by four ground emergency medical services agencies completed a 22-question written survey that assessed Surgical Airway attempts, training, skills verification, and perceptions about procedural competency. Descriptive statistics were used to evaluate responses. Results: Only 20% (17/86, 95% CI [11-28%]) of paramedics had attempted cricothyrotomy, most (13/17 or 76%, 95% CI [53-90%]) of whom had greater than 10 years experience. Most subjects (63/86 or 73%, 95% CI [64-82%]) did not reply that they are well-trained to perform cricothyrotomy and less than half (34/86 or 40%, 95% CI [30-50%]) felt they could correctly perform cricothyrotomy on their first attempt. Among subjects with five or more years of experience, 39/70 (56%, 95% CI [44-68%]) reported 0-1 hours per year of practical cricothyrotomy training within the last five years. Half of the subjects who were able to recall (40/80, 50% 95% CI [39-61%]) reported having proficiency verification for cricothyrotomy within the past five years. Conclusion: Paramedics surveyed indicated that cricothyrotomy is rarely performed, even among those with years of experience. Many paramedics felt that their training in this area is inadequate and did not feel confident to perform the procedure. Further study to determine whether to modify paramedic scope of practice and/or to develop improved educational and testing methods is warranted.