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Difficult Airway Database - an update
| Achuthan Sajayan |
DAS Difficult airway database is continuing its expansion across the country and several national organisations have confirmed their official support to the project in the last few months. The following is the list of organisations supporting us:
✦ Society for Obesity and Bariatric Anaesthesia (SOBA)
✦ Association of Anaesthetists (AoA)
✦ Obstetric Anaesthetists Association (OAA)
✦ Royal College of Anaesthetists (RCoA)
✦ Safe Anaesthesia Liaison Group (SALG)
✦ Association for Perioperative Practice (AfPP)
✦ College of Operating Department
Practitioners (CODP)
✦ Society for Education in Anaesthesia (SEA-
UK)
✦ UK Society for Computing and Technology in
Anaesthesia (SCATA-UK)
✦ Intensive Care Society (ICS)
Here is the comparison of current figures with those from September 2021:
Sept 21 Current Status
150 Hospital sites 190
820+ submissions 1200+
1935 Access logins 2500+
The analysis of the data collected over the first five years has very recently been published in Anaesthesia! Here's the link If your hospital is not yet part of this project and you are interested in taking the lead role locally, please do get in touch with us via dad@das.uk.com. If you work in a hospital which is already a part of the project, please encourage your colleagues to submit the data promptly and let us know if you have any feedback about the project or the process of submission.
Some useful links are: DAS Database main page and the list of Trusts currently taking part in the project. Other project related documents can be found here.
Dr Achuthan Sajayan dad@das.uk.com
Co-Lead, DAS Difficult Airway Database
DAS Airway Alert Card and Difficult Airway
Database - How to join the project? -----------------------------------------------------
Check if your hospital is already on the project https://das.uk.com/content/dad _ sites If not, please follow the steps below
How to submit a case to the DAS Database?
https://das.uk.com/dad
Consent
Download the patient information and consent form from the DAS website https://das.uk.com/aac/con sent_form
Discuss with the patient and obtain the consent. Please make sure the patient has recovered fully from the effects of anaesthesia. Recovery room is not a recommended place for consenting.
Give one copy to the patient and keep one in the records
Data submission
If you are not a DAS member, you need to register with the database before submitting data. Registration is free and only takes few minutes.
Please follow this link https://das.uk.com/das_user/ acaregister
Summary document
Once the data is submitted, there will be an option to print out the summary of the event. Please print two copies, give one to the patient and keep the other in the patient records.
There will also be an option to print out a letter to the GP. This can either be sent directly to the GP or give it to the patient with instructions to hand over to their GP.
If you are a trainee or specialty doctor, please discuss with your supervising consultant before submitting the data and provide their name
GP letter
WORLD AIRWAY MANAGEMENT MEETING
| Ellen O’Sullivan |
Following on from the success of WAMM1, held in Dublin in 2015, and WAMM 2 in Amsterdam in 2019 we plan to run a WAMM 3. Dates and venues are presently being discussed.
WATCH THIS SPACE!
FURTHER ANNOUNCEMENTS COMING SOON!
| References 1/2 |
1. NELA Project Team. Seventh Patient Report of the National Emergency Laparotomy Audit. (2021). https:// www.nela.org.uk/Seventh-Patient-Report
2. Hewitt, J., Carter, B., McCarthy, K., Pearce, L., Law, J., Wilson, F. V., Tay, H. S., McCormack, C., Stechman, M. J., Moug, S. J., & Myint, P. K. (2019). Frailty predicts mortality in all emergency surgical admissions regardless of age. An observational study. Age and ageing, 48(3), 388–394. https://doi.org/10.1093/ageing/afy217
3. Parker, S. G., McCue, P., Phelps, K., McCleod, A., Arora, S., Nockels, K., Kennedy, S., Roberts, H., & Conroy, S. (2018). What is Comprehensive Geriatric Assessment (CGA)? An umbrella review. Age and ageing, 47(1), 149–155. https://doi.org/10.1093/ageing/afx166
4. Partridge, J. S. L., Healey, A., Modarai, B., Harari, D., Martin, F. C., & Dhesi, J. K. (2021). Preoperative comprehensive geriatric assessment and optimisation prior to elective arterial vascular surgery: a health economic analysis. Age and ageing, 50(5), 1770–1777. https://doi.org/10.1093/ageing/afab094
5. Partridge, J. S., Harari, D., Martin, F. C., Peacock, J. L., Bell, R., Mohammed, A., & Dhesi, J. K. (2017). Randomized clinical trial of comprehensive geriatric assessment and optimization in vascular surgery. The British journal of surgery, 104(6), 679–687. https://doi.org/10.1002/bjs.10459
6. Kocman, D., Regen, E., Phelps, K., Martin, G., Parker, S., Gilbert, T., & Conroy, S. (2019). Can comprehensive geriatric assessment be delivered without the need for geriatricians? A formative evaluation in two perioperative surgical settings. Age and ageing, 48(5), 644–649. https://doi.org/10.1093/ageing/afz025
7. Centre for Perioperative Care, British Geriatrics Society. (2021). Guideline for Perioperative Care for People Living with Frailty Undergoing Elective and Emergency Surgery. https://www.cpoc.org.uk/sites/cpoc/files/documents/2021-09/ CPOC-BGS-Frailty-Guideline-2021.pdf
8. Rogerson, A., Partridge, J. S. L., & Dhesi, J. K. (2018). A Foundation Programme educational placement in perioperative medicine for older people: mixed methods evaluation. Anaesthesia, 73(11), 1392–1399. https://doi.org/ 10.1111/anae.14410 Workstreams – Getting It Right First Time – GIRFT. (n.d.). Retrieved December 6, 2022, from https://www.gettingitrightfirsttime.co.uk/workstreams/
| References 2/2 |
9. Joughin, A. L., Partridge, J. S. L., O'Halloran, T., & Dhesi, J. K. (2019). Where are we now in perioperative medicine? Results from a repeated UK survey of geriatric medicine delivered services for older people.Age and ageing,48 (3), 458–462. https://doi.org/10.1093/ageing/afy218
10. Jasper, E. V., Dhesi, J. K., Partridge, J. S., & Sevdalis, N. (2019). Scaling up perioperative medicine for older people undergoing surgery (POPS) services; use of a logic model approach. Clinical medicine (London, England), 19(6), 478–484. https://doi.org/10.7861/clinmed.2019-0223
DEVELOPING A PERIOPERATIVE SERVICE PREHABILITATION AT UCLH
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1. NHS select; Kotter’s 8 steps of change. Website Address: https://www.nhselect.nhs.uk/uploads/files/1/ Kotter%27s%208%20steps%20of%20change.pdf)
2. Dixon-Woods M, McNicol S, Martin G. Ten challenges in improving quality in healthcare: lessons from the Health Foundation’s programme evaluations and relevant literature. BMJ Qual Saf. 2012. Doi:10.1136/bmjqs-2011-000760
3. Centre for Perioperative Care. Delivering on Government priorities and for an NHS in crisis; Investing in perioperative care pathfinders. Sept 2021. Website Address: https://cpoc.org.uk/sites/cpoc/files/documents/2021-10/ The%20Centre%20for%20Perioperative%20Care%20HMT%20Representation%20Sept%202021.pdf
4. https://wessexcanceralliance.nhs.uk/wesfit-project/
5. http://www.prehab4cancer.co.uk/
6. Barberan-Garcia A, et al. Personalised prehabilitation in high-risk patients undergoing elective major abdominal surgery: A randomised blinded control trial. Ann Surg. 2018 Jan. 267(1):50-56
7. Jensen BT, Petersen AK, Jensen JB, Lausten S, Borre M. Efficacy of a multiprofessional rehabilitation programme in radical cystectomy pathways: a prospective randomized controlled trial. Scand J Urol. 2015 April; 49(2):133-41.
8. Nilsson H, et al. Is preoperative physical activity related to post-surgical recovery? A cohort study of patients with breast cancer. BMJ Open. 2016;6:e007997.
9. Website address: http://www.prehab4cancer.co.uk/success-stories/
LIDOCAINE LEAN BODY WEIGHT DOSING CHARTS FOR AWAKE TRACHEAL INTUBATION TOPICALISATION
| References 1/1 |
1. Ahmad I, El-Boghdadly K, Bhagrath R et al. Difficult Airway Society guidelines for awake tracheal intubation (ATI) in adults. Anaesthesia 2020;75:509–528.
2. Woodall NM, Harwood RJ, Barker GL. Complications of awake fibreoptic intubation without sedation in 200 healthy anaesthetists attending a training course. BJA 2008;100(6):850-855.
3. Williams KA, Barker GL, Harwood RJ, Woodall NM. Combined nebulization and spray-as-you-go topical local anaesthesia of the airway. BJA. 2005; 95: 549-553
4. Janmahasatian S, Duffull SB, Ash S, et al. Quantification of lean bodyweight. Clin Pharmacokinet 2005; 44: 1051–1065.
GA SECTIONS - POLLS FROM DAS 2022
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1. Schutzer-Weissmann J, Wojcikiewicz T, Karmali A, Lukosiute A, Sun R, Kanji R, Ahmed AR, Purkayastha S, Brett SJ, Cousins J. Apnoeic oxygenation in morbid obesity: a randomised controlled trial comparing facemask and highflow nasal oxygen delivery. Br J Anaesth. 2022 Jan 11:S0007-0912(21)00800-X. doi: 10.1016/j.bja.2021.12.011. Epub ahead of print. PMID: 35027169.
2. Shippam W, Preston R, Douglas J, Taylor J, Albert A, Chau A. High-flow nasal oxygen vs. standard flow-rate facemask pre-oxygenation in pregnant patients: a randomised physiological study. Anaesthesia. 2019; 74: 450-456.
3. Zhou S, Zhou Y, Cao X, Ni X, Du W, Xu Z, Liu Z. The efficacy of high flow nasal oxygenation for maintaining maternal oxygenation during rapid sequence induction in pregnancy: A prospective randomised clinical trial. Eur J Anaesthesiol. 2021 Oct 1;38(10):1052-1058. doi: 10.1097/EJA.0000000000001395. PMID: 33259452.
4. Mir F, Patel A, Iqbal R, Cecconi M, Nouraei SAR. A randomised controlled trial comparing transnasal humidified rapid insufflation ventilatory exchange (THRIVE) pre-oxygenation with facemask pre-oxygenation in patients undergoing rapid sequence induction of anaesthesia. Anaesthesia. 2017; 72(4): 439-443.
5. Lodenius A, Piehl J, Ostlund A, Ullman J, Josson Fagerlund M. Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) vs. facemask breathing pre-ixygenation in adults: a prospective randomised non-blinded clinical trial. Anaesthesia. 2018; 73: 564-71.
6. Lucas DN, Russell R. Pre-oxygenation vs. apnoeic oxygenation in obstetrics. Anaesthesia. 2019; 74(6): 822-823.
7. Ide A, Nozaki-Taguchi N, Sato S, Saito K, Sato Y, Isono S. Rocuronium versus saline for effective facemask ventilation during anaesthesia induction: a double-blinded randomized placebo-controlled trial. BMC Anaesthesiol. 2022; 22(1): 173.
8. https://www.oaa-anaes.ac.uk/assets/_managed/cms/files/Clinical%20Guidelines/Guideline_Algorithms_2015.pdf
9. White LD, Hodsdon A, An GH, Thang C, Melhuish TM, Vlok R. Induction opioids for caesarean section under general anaesthesia: a systematic review and meta-analysis of randomised controlled trials. Int J Obstet Anesth. 2019; 40:4-13.
10. Trent SA, Kaji AH, Carlson JN, McCormick T, Haukoos JS, Brown CA. Video Laryngoscopy is associated with first-pass success in emergency department intubations for trauma patients: a propensity score matched analysis of the national emergency airway registry.
Difficult Airway Society
